Newborn Hearing Screening in Bavaria—Is It Possible to Reach the Quality Parameters?

Abstract

Since the 1 January, 2009, newborn hearing screening (NHS) has been obligatory for every child in Germany. NHS is part of the Pediatrics Directive of the Federal Joint Committee. In this directive, details of the procedures and screening quality to be achieved are given. We evaluate if these quality criteria were met in Bavaria in 2016. The NHS data of children born in 2016 in Bavaria were evaluated for quality criteria, such as screening coverage in screening facilities, screening methods, referral rate (rate of failed tests at discharge) and a child’s age at the diagnosis of a hearing disorder. NHS was documented for 116,776 children born in Bavaria in 2016. In the first step, 78,904 newborns were screened with transient evoked otoacoustic emissions and 37,865 with automated auditory brainstem response. Of these, 9182 (7.8%) failed the first test in one or both ears. A second screening before discharge was performed on 53.3% of the newborns with a refer result in the first test, out of which 58.7% received a pass result. After the screening process, 4.6% of the newborns were discharged with a refer result. Only 18% of the first controls after discharge were performed by a pediatric audiologist. In 37.9% of the newborns, the screening center intervened to assure the control of any failed screening test. The median age of diagnosis for bilateral hearing loss was 5.3 months. In Bavaria, NHS was implemented successfully. A tracking system for all children who failed the hearing screening test is pivotal for early diagnosis and therapy of children with hearing deficiency.

A 10-year retrospective analysis of newborn hearing screening in a tertiary hospital in Malaysia

“…These findings are consistent with studies in developed countries that report 1-3 cases of childhood hearing loss per 1000 live birth [1]. In other programs, such as in Bavaria, Germany, the prevalence of hearing loss only includes those with bilateral hearing loss [26]. Unilateral referrals were included in the present study because they can also negatively impact the children's developmental and educational outcomes [27].…”

Availability of data for cost-effectiveness comparison of child vision and hearing screening programmes

“…Data are often collected for quality assurance, for example to keep track of children lost to follow-up. 15 , 16 Committees, guidelines and studies that advocate data collection, also do so for the purpose of quality assurance. 3 , 17 , 18 Data may also be collected for the purpose of accountability to commissioners of screening programmes or other stakeholders.…”

Evaluation eines Screening-Programms: Herausforderungen der Datenerhebung am Beispiel des Neugeborenen-Hörscreenings

“…Ein Problem war die unterschiedliche Dokumentation der Einzeldatensätze in den einzelnen Zentralen. Trotz vorheriger Bemühungen um eine Vereinheitlichung der Daten 17 und einer in Zusammenarbeit mit den Hörscreening-Zentralen erstellten Liste mit eindeutig definierten Variablen, zeigten sich bei der Erhebung der Einzeldatensätze deutliche Unterschiede. Nicht alle Variablen konnten in allen Zentralen erfasst werden (z.…”