新生儿听力查的两阶段质量测量:系统性审查和元分析
Kirsi Manz1,2, Uta Nennstiel3, Carola Marzi3
1Faculty of Medicine, Institute for Medical Information Processing, Biometry and Epidemiology (IBE), LMU Munich, Munich, Germany.
Frontiers in public health
|May 1, 2025
概括
为了最佳的新生儿听力查 (NHS),避免在第一阶段和第二阶段之间更改测试方法. 使用相同的方法,比如自动听力脑干反应 (AABR) 两次,产生最低的参考率 (RFR).
科学领域:
- 公共卫生 公共卫生
- 听力学 听力学是指听力学.
- 新生儿护理 新生儿护理
背景情况:
- 针对听力障碍 (NHS) 的新生儿查是一个关键的全球卫生倡议.
- 通常采用双阶段查协议,通常使用不同的测试方式.
- 参考率 (RFR),表示婴儿没有通过第二次测试或丢失后续,是评估查效率的关键指标.
研究的目的:
- 为了确定新生儿听力障碍的最佳查算法.
- 综合关于NHS二阶段算法的证据,重点关注参考率 (RFR).
- 评估在第一阶段和第二阶段之间改变选方法对RFR的影响.
主要方法:
- 在MEDLINE和Scopus上进行了系统的文献搜索,以寻找两阶段NHS的研究.
- 包括使用过渡唤起的耳声发射 (TEOAE) 或自动听力脑干反应 (AABR) 的研究.
- 使用随机效应元分析估计RFR;使用QUADAS-II评估偏差风险.
主要成果:
- 八十五项研究,包括超过1120,000名新生儿,符合纳入标准.
- 保持相同查方法的策略显示了较低的RFR:AABR-AABR (1.3%),TEOAE-TEOAE (2.7%).
- 改变查方法导致RFR更高:TEOAE-AABR (3.9%) 和AABR-TEOAE (5.9%).
结论:
- 为了尽量减少后续检查,尽可能避免在NHS的第一阶段和第二阶段之间更改查方法.
- 在两个查阶段一致使用AABR或TEOAE与降低推率有关.
- 证据确定性被评为中度,支持这些发现优化NHS协议.
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