Screening for hearing loss and middle-ear effusion in school-age children, using transient evoked otoacoustic emissions: a feasibility study

Georgalas, Christos; Xenellis, John; Davilis, Dimitris; Tzangaroulakis, A.; Ferekidis, Eleftherios

doi:10.1017/s0022215108002156

Cited by 27 publications

(39 citation statements)

References 16 publications

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“…Briefly, 10 primary studies were included in this update. 17,[22][23][24][25][26][27][28][29][30] One was published before 2005 24 but was included here as it had been missed by the original 2007 HTA report. 12 The other nine studies were published in the period 2005-2014.…”

Section: Search Results and Selection Of Studiesmentioning

confidence: 99%

A programme of studies including assessment of diagnostic accuracy of school hearing screening tests and a cost-effectiveness model of school entry hearing screening programmes

Fortnum

Ukoumunne

Hyde

et al. 2016

Health Technol Assess

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BackgroundIdentification of permanent hearing impairment at the earliest possible age is crucial to maximise the development of speech and language. Universal newborn hearing screening identifies the majority of the 1 in 1000 children born with a hearing impairment, but later onset can occur at any time and there is no optimum time for further screening. A universal but non-standardised school entry screening (SES) programme is in place in many parts of the UK but its value is questioned.ObjectivesTo evaluate the diagnostic accuracy of hearing screening tests and the cost-effectiveness of the SES programme in the UK.DesignSystematic review, case–control diagnostic accuracy study, comparison of routinely collected data for services with and without a SES programme, parental questionnaires, observation of practical implementation and cost-effectiveness modelling.SettingSecond- and third-tier audiology services; community.ParticipantsChildren aged 4–6 years and their parents.Main outcome measuresDiagnostic accuracy of two hearing screening devices, referral rate and source, yield, age at referral and cost per quality-adjusted life-year.ResultsThe review of diagnostic accuracy studies concluded that research to date demonstrates marked variability in the design, methodological quality and results. The pure-tone screen (PTS) (Amplivox, Eynsham, UK) and HearCheck (HC) screener (Siemens, Frimley, UK) devices had high sensitivity (PTS ≥ 89%, HC ≥ 83%) and specificity (PTS ≥ 78%, HC ≥ 83%) for identifying hearing impairment. The rate of referral for hearing problems was 36% lower with SES (Nottingham) relative to no SES (Cambridge) [rate ratio 0.64, 95% confidence interval (CI) 0.59 to 0.69;p < 0.001]. The yield of confirmed cases did not differ between areas with and without SES (rate ratio 0.82, 95% CI 0.63 to 1.06;p = 0.12). The mean age of referral did not differ between areas with and without SES for all referrals but children with confirmed hearing impairment were older at referral in the site with SES (mean age difference 0.47 years, 95% CI 0.24 to 0.70 years;p < 0.001). Parental responses revealed that the consequences to the family of the referral process are minor. A SES programme is unlikely to be cost-effective and, using base-case assumptions, is dominated by a no screening strategy. A SES programme could be cost-effective if there are fewer referrals associated with SES programmes or if referrals occur more quickly with SES programmes.ConclusionsA SES programme using the PTS or HC screener is unlikely to be effective in increasing the identified number of cases with hearing impairment and lowering the average age at identification and is therefore unlikely to represent good value for money. This finding is, however, critically dependent on the results of the observational study comparing Nottingham and Cambridge, which has limitations. The following are suggested: systematic reviews of the accuracy of devices used to measure hearing at school entry; characterisation and measurement of the cost-effectiveness of different approaches to the ad-hoc referral system; examination of programme specificity as opposed to test specificity; further observational comparative studies of different programmes; and opportunistic trials of withdrawal of SES programmes.Trial registrationCurrent Controlled Trials ISRCTN61668996.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 36. See the NIHR Journals Library website for further project information.

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Section: Search Results and Selection Of Studiesmentioning

confidence: 99%

A programme of studies including assessment of diagnostic accuracy of school hearing screening tests and a cost-effectiveness model of school entry hearing screening programmes

Fortnum

Ukoumunne

Hyde

et al. 2016

Health Technol Assess

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“…15 While comparing the type of tympanogram in referred population B type was most common found followed by C type and As type. A study on Otoacoustic emissions in a screening on school-age children reported that 20% children failed in both ears and 32% in at least one ear 16 . In the present study the refer rate was reported separately for the right (29.1%) and the left (33.1%) The difference in the two studies may be credited to the factors like awareness among the population, difference of geographical areas and availability of medical facilities.…”

Section: Whomentioning

confidence: 99%

Hearing Screening in Primary School Children: An Overview

Ojha,

Kumar,

Nandurkar

2106

IJCHMR

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Corresponding author: Satish kumar, Lecturer (Audiology), Department of ENT, GGS Medical College Faridkot,Punjab.Email: vermastsh@yahoo.co.in NTRODUCTIONConductive hearing impairment is very commonly encountered in school going years, extending from mild to moderately severe in degree and can be due to various causes mainly middle ear infections (otitis media, glue ear) and many other squeal associated with serous otitis media such as chronic otitis media and cholesteatoma. Studies suggest that even a brief period of auditory deprivation caused due to a conductive or a fluctuating hearing loss can result in deviations of the neural topography of a child.1 Because of the time spent with reduced hearing, children with more persistent or recurrent bouts of glue ear are at risk of delayed language, difficulties learning to read, gap in general knowledge, difficulty in reasoning ability and social, behavioral problems.2 Jerger 3 estimated that I Original ArticleBackground:Hearing impairment is very commonly encountered in school going children, if not identified early it can lead to deviation of the neural topography of the child along with social, behavioral and communication problems. The aim of this research is to conduct a screening program for primary school going children to provide sufficient reliable data on the occurrence of hearing impairment and its relationship to age and gender. Materials and methods: In this cross sectional study a convenient sample consisting of 1516 primary school going children from Bikaner were screened for hearing loss. Subjects were divided in four grades viz. Grade 1: 423 children (3-11 yrs), Grade 2: 393 children (5-13 yrs), Grade 3: 302 children (6-12years) and Grade 4: 398 children (6-14 years). Primary information was obtained through case history then otoscopy examination, Pure Tone screening, tympanometric screening and DPOAES screening performed on the subjects. Data was obtained and analyzed by Pearson's chi-square test. Results: Finding revealed 13.7% males and 17.6% females with hearing impairment further refer rate was more fore left ear compared to the right ear. Overall the refer rate was found more for females in both the ears at all screened frequencies and observed highest for the Grade 1. Pearson's chi-square test suggested spastically significant difference in refer rate among both gender and grades. Conclusion: The present study suggested that there is high prevalence of hearing loss in primary school going children which varies among different grades and gender. Negligence, lack of awareness and delay in promptness for pursuing regular hearing health care service are major causes for current findings. Data obtained from the present study emphasizes the role of annual hearing screening programs for school going children to promote the general health care, education, social and emotional adjustment.

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“…Penelitian Georgalas dkk., 11 Grundfast dkk., 12 dan WHO 2 pada anak sekolah dasar, OME merupakan penyebab gangguan dengar yang paling banyak ditemukan. Pada penelitian diagnosis OME juga paling banyak ditemukan (Tabel 1).…”

Section: Pembahasanunclassified

“…Hasil ini tidak terlalu jauh berbeda dengan penelitian skrining pendengaran dan otitis media pada anak sekolah yang dilakukan oleh Georgalas dkk., 11 yaitu didapatkan perbandingan laki-laki dengan perempuan 1,08:1 serta perbandingan penelitian Ratunanda 8 pada anak kelas satu tersangka OME di beberapa sekolah dasar kota Bandung dengan perbandingan 1,5:1.…”

Section: Pembahasanunclassified

Tingkat Ketepatan Audiometer Skrining Medan Bebas untuk Mendeteksi Gangguan Dengar Anak Sekolah Dasar dengan Otitis Media

Hartanto¹,

Boesoirie²,

Poerwana³

2013

mkb

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AbstrakSkrining pendengaran pada anak sekolah dapat mengetahui lebih dini gangguan dengar akibat otitis media sehingga hasil pengobatannya akan lebih baik. Audiometer skrining medan bebas merupakan alat skrining pendengaran yang sederhana, terjangkau, ringkas, mudah dan singkat, tetapi belum diukur tingkat ketepatannya untuk anak sekolah dasar. Penelitian ini bertujuan untuk menguji tingkat ketepatan audiometer skrining medan bebas untuk mendeteksi gangguan dengar pada anak sekolah dasar yang menderita otitis media. Penelitian uji diagnostik dengan rancangan penelitian potong silang dilakukan di Sekolah Dasar Sejahtera dan Poliklinik Departemen Ilmu Kesehatan Telinga Hidung Tenggorok-Bedah Kepala dan Leher RS Dr. Hasan Sadikin Bandung periode bulan Juni-Agustus 2011. Dari 479 anak sekolah dasar, didapatkan 86 subjek sesuai kriteria inklusi. Terdapat gangguan dengar pada 56 anak yang diperiksa audiometer skrining medan bebas dan 51 anak yang diperiksa audiometri nada murni. Hasil uji diagnostik audiometer skrining medan bebas didapatkan sensitivitas 90,2%; spesifisitas 71,4%; indeks Kappa 0,630. Perbandingan pemeriksaan pendengaran antara audiometri skrining medan bebas dan audiometri nada murni didapatkan p=0,302. Simpulan, tingkat ketepatan audiometer skrining medan bebas sama dengan audiometer nada murni untuk mendeteksi gangguan dengar anak sekolah dasar yang menderita otitis media. Accuracy of Portable Screening Audiometer for Detecting Hearing Loss in Elementary School Children with Otitis Media AbstractHearing skrining in school children can detect hearing loss due to otitis media earlier therefor treatment will give better outcome. Portable screening audiometer is a device which are simple, less expensive, brief, easy to use and has shorter examination time but has not been measured its accuracy for hearing screening in elementary school children. The objective of this study was to measure the accuracy of portable screening audiometry for detecting hearing loss in elementary school children with otitis media. A diagnostic test study with cross-sectional method was conducted at Sejahtera Elementary School and at Out-patient Clinic Otorhinolaryngology-Head and Neck Department Dr. Hasan Sadikin Hospital Bandung period June until August 20011. From 479 children, there were 86 children match with inclusion criteria. Hearing loss was found in 56 children examined using portable screening audiometer and in 51 children using pure tone audiometry. Diagnostic test result for portable screening audiometer were 90.2% sensitivity, 71.4% specificity, with Kappa index 0.630 and p value was 0.302 compared to pure tone audiometry. In conclusion, the accuracy of portable screening audiometer is as good as pure tone audiometry in order to detect hearing loss in elementary school children with otitis media. [MKB. 2013;45(1):62-68]

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Screening for hearing loss and middle-ear effusion in school-age children, using transient evoked otoacoustic emissions: a feasibility study

Abstract: These results strongly suggest the potential usefulness of otoacoustic emission testing in screening school-age children for hearing loss. Further studies, taking into account cost-effectiveness issues, are indicated.

Cited by 27 publications

References 16 publications

A programme of studies including assessment of diagnostic accuracy of school hearing screening tests and a cost-effectiveness model of school entry hearing screening programmes

A programme of studies including assessment of diagnostic accuracy of school hearing screening tests and a cost-effectiveness model of school entry hearing screening programmes

Hearing Screening in Primary School Children: An Overview

Tingkat Ketepatan Audiometer Skrining Medan Bebas untuk Mendeteksi Gangguan Dengar Anak Sekolah Dasar dengan Otitis Media

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