Does the involvement of first-year residents have a negative impact on the performance of a newborn hearing screening program?

Gallus, Roberto; Rizzo, Davide; Luca, Laura Maria De; Melis, Andrea; Kihlgren, Caterina; Parente, Paolo; Anzivino, Roberta; Frezza, Simonetta; Priolo, Francesca; Bussu, Francesco; Conti, Guido

doi:10.1016/j.ijporl.2020.110270

Cited by 3 publications

(5 citation statements)

References 21 publications

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“…Other studies compared WB with infants admitted to the NICU b Risk ratio cannot be calculated with a LTFU rate of 0% with OAE compared to aABR, which was newly trained and practiced prior to commencement of the study. It was unclear from the studies in this systematic review if practice alone improves referral rate [71,75,76]: though, part of improving the quality of the programme could involve other aspects related to experience, such as planning the optimal time for OAE screening to accommodate the behaviour of the [49,55], networking with larger hospitals [75], or embedding smaller NHS programmes into a larger programme [78,79]. If aABR screening is being considered as the primary screening method for WB, policymakers should also consider the challenges associated with a new technology and consider the advantages and disadvantages in relation to the current quality of their programme.…”

Section: Discussionmentioning

confidence: 92%

“…A more experienced screener had lower referral rates compared to a less experienced screener according to one study, but only with OAE and not with aABR [70]. Another study showed no learning curve for OAE in four groups of screeners across a 12-month period [71]. Two studies showed that hospitals with more annual births were more successful at achieving low referral rates [75,76].…”

Section: Not Relevant 35%mentioning

confidence: 97%

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Protocol and programme factors associated with referral and loss to follow-up from newborn hearing screening: a systematic review

et al. 2022

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Background An effective newborn hearing screening programme has low referral rate and low loss to follow-up (LTFU) rate after referral from initial screening. This systematic review identified studies evaluating the effect of protocol and programme factors on these two outcomes, including the screening method used and the infant group. Methods Five databases were searched (latest: April 2021). Included studies reported original data from newborn hearing screening and described the target outcomes against a protocol or programme level factor. Studies were excluded if results were only available for one risk condition, for each ear, or for < 100 infants, or if methodological bias was observed. Included studies were evaluated for quality across three domains: sample, screening and outcome, using modified criteria from the Ottawa-Newcastle and QUADAS-2 scales. Findings from the included studies were synthesised in tables, figures and text. Results Fifty-eight studies reported on referral rate, 8 on LTFU rate, and 35 on both. Only 15 studies defined LTFU. Substantial diversity in referral and LTFU rate was observed across studies. Twelve of fourteen studies that evaluated screening method showed lower referral rates with aABR compared to TEOAE for well babies (WB). Rescreening before hospital discharge and screening after 3 days of age reduced referral rates. Studies investigating LTFU reported lower rates for programmes that had audiologist involvement, did not require fees for step 2, were embedded in a larger regional or national programme, and scheduled follow-up in a location accessible to the families. In programmes with low overall LTFU, higher LTFU was observed for infants from the NICU compared to WB. Conclusion Although poor reporting and exclusion of non-English articles may limit the generalisability from this review, key influential factors for referral and LTFU rates were identified. Including aABR in WB screening can effectively reduce referral rates, but it is not the only solution. The reported referral and LTFU rates vary largely across studies, implying the contribution of several parameters identified in this review and the context in which the programme is performed. Extra attention should be paid to infants with higher risk for hearing impairment to ensure their return to follow-up.

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Section: Discussionmentioning

confidence: 92%

Section: Not Relevant 35%mentioning

confidence: 97%

Protocol and programme factors associated with referral and loss to follow-up from newborn hearing screening: a systematic review

et al. 2022

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“…During this phase, relevant prenatal and perinatal audiological risk factors are investigated and recorded. The two possible results of this first stage are “Pass” or “Refer” [ 9 ]. Non-NICU babies without known audiological risk factors and “Pass” result at the universal screening exit the screening program.…”

Section: Methodsmentioning

confidence: 99%

“…As defined by the American Academy of Pediatrics, the referral standard from the first stage should be <4% and the dropout rate at follow-up should be <5%, but this rate is typically higher in real world settings [ 4 ]. With the implementation of UNHS programs, a steady flow of data coming from some of them has been published, allowing for a deeper understanding of the expected and unexpected associated problems, such as costs [ 5 ], settings, technologies involved [ 6 ], referral rates [ 7 ], dropout rates [ 8 ], type of operators involved [ 9 ], and risk factors requiring special consideration [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Audiological Risk Factors, Referral Rates and Dropouts: 9 Years of Universal Newborn Hearing Screening in North Sardinia

Luca

Malesci

Gallus³

et al. 2022

Children

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Background: Objectives of the present work were to analyze the prevalence of hearing loss in our population of screened newborns during the first 9 years of the universal newborn hearing screening (UNHS) program at University Hospital Sassari (Italy) (AOU Sassari), to analyze the risk factors involved, and to analyze our effectiveness in terms of referral rates and dropout rates. Methods: Monocentric retrospective study whose target population included all the newborns born or referred to our hospital between 2011 and 2019. Results: From 2011 to 2019, a total of 11,688 babies were enrolled in our screening program. In total, 3.9‰ of wellborn babies and 3.58% of neonatal intensive care unit (NICU) babies had some degree of hearing loss. The most frequently observed risk factors among non-NICU babies were family history of hearing loss (3.34%) and craniofacial anomalies (0.16%), among NICU babies were low birth weight (54.91%) and prematurity (24.33%). In the multivariate analysis, family history of hearing loss (p < 0.001), NICU (p < 0.001), craniofacial anomalies (p < 0.001), low birth weight (<1500 g) (p = 0.04) and HIV (p = 0.03) were confirmed as risk factors. Conclusions: Our data are largely consistent with the literature and most results were expected, one relevant exception being the possible role of NICU as a confounding factor and the limited number of risk factors confirmed in the multivariate analysis.

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“…This metric can also be used to inform decision-making when there are limited resources. Therefore, we understand that one of the relevant factors to determine the success of a UNHS program is the cost-effectiveness ratio 7 to identify the factors that affect its performance as a whole. 8 Public policy makers have a position regarding the attention given to cost-effective interventions in hearing health, aiming to reduce the consequences of hearing loss.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of Neonatal Hearing Screening Programs: Systematic Review

Vernier,

Fernandes,

Skorin

et al. 2024

Int Arch Otorhinolaryngol

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Introduction Universal newborn hearing screening (UNHS) has been widely and strongly advocated as an early detection strategy for hearing loss in children. This intervention aims to prevent delays in speech and language development, which, in turn, has long-term beneficial effects on the social and emotional development and quality of life of individuals. However, the implementation of UNHS programs is circumstantial in different settings, for different reasons. Objectives The present systematic review aimed to identify whether the implementation of UNHS programs are cost-effective, as well as their variations by localities. Data Synthesis A search was conducted in seven databases: PubMed (Medline), Scopus, Web of Science, Embase, CINAHL, Lilacs, and Cochrane Library. Studies that included a cost analysis of UNHS programs were eligible for inclusion. Studies on evaluations of preschool or school-based programs only were excluded, among others. A total of 1,291 records were found. Of these, 23 articles were analyzed in full. All articles identified the cost-effectiveness of the UNHS programs implemented. Regarding the UNHS protocols, a wide variation was observed in all aspects: tests used, period established between tests and retests, professionals responsible for screening, environment, and criteria for defining hearing loss, limiting the generalization of this information. All studies presented values related to the expenses with the program, but none of them showed statistical elements for the described analyzes or any theoretical basis for such. Conclusion It is necessary to estimate local specific issues, as well as the accuracy of the chosen tests and the NHS protocols used, so that more accurate analyzes on cost-effectiveness are possible.

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Does the involvement of first-year residents have a negative impact on the performance of a newborn hearing screening program?

Cited by 3 publications

References 21 publications

Protocol and programme factors associated with referral and loss to follow-up from newborn hearing screening: a systematic review

Protocol and programme factors associated with referral and loss to follow-up from newborn hearing screening: a systematic review

Audiological Risk Factors, Referral Rates and Dropouts: 9 Years of Universal Newborn Hearing Screening in North Sardinia

Cost-effectiveness of Neonatal Hearing Screening Programs: Systematic Review

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