Ten‐year quality assurance of the nationwide hearing screening programme in Dutch neonatal intensive care units

Dommelen, Paula van; Straaten, Hlm van; Verkerk, P.H.

doi:10.1111/j.1651-2227.2011.02230.x

Cited by 31 publications

(28 citation statements)

References 18 publications

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“…Furthermore, the NHSP in Dutch NICUs is highly effective with a low loss to follow-up, due, among other reasons, to the electronic registration system that facilitates screening, tracking, and followup after abnormal screening results. 13 Coverage rates for this program are 98.7% at the first, 92.1% at the second stage, 92.3% for diagnostic examination, and 97.9% for the complete program. 13 Therefore, the prevalence rates are assumed to be unbiased.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hearing Loss by Week of Gestation and Birth Weight in Very Preterm Neonates

Dommelen¹,

Verkerk

Straaten

et al. 2015

The Journal of Pediatrics

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Section: Discussionmentioning

confidence: 99%

“…13 Coverage rates for this program are 98.7% at the first, 92.1% at the second stage, 92.3% for diagnostic examination, and 97.9% for the complete program. 13 Therefore, the prevalence rates are assumed to be unbiased.…”

Section: Discussionmentioning

confidence: 99%

Hearing Loss by Week of Gestation and Birth Weight in Very Preterm Neonates

Dommelen¹,

Verkerk

Straaten

et al. 2015

The Journal of Pediatrics

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“…The introduction of the highly sensitive and specific Universal Newborn Hearing Screening (UNHS) programme has led to the identification of the vast majority of children born with a hearing impairment who undergo the screen. 3,4 However, not all children who will ultimately have a hearing impairment are identifiable at birth. Data published in 2001 5 reported an adjusted prevalence of permanent hearing impairment of > 40 dB (average of 0.5, 1, 2 and 4 kHz) at age 3 years of 1.07 per 1000 and a prevalence for children aged 9-15 years of 2.05 per 1000.…”

Section: Chapter 1 Background and Main Questionsmentioning

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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“…Universal newborn hearing screening (UNHS) was recommended by the American Academy of Pediatrics in 1999 [6] and has proved to be safe and effective in the early detection of hearing loss after birth [1,2,4,5,6,7], allowing early intervention and improvement of the verbal development in children with congenital hearing loss [1,5,6,7]. …”

Section: Introductionmentioning

confidence: 99%

“…Hearing loss occurs in 1-6/1,000 liveborn infants [1,2,3] and may be associated with significant developmental delay in infancy and childhood, including verbal, mental, emotional and social impairments [1,4,5]. Universal newborn hearing screening (UNHS) was recommended by the American Academy of Pediatrics in 1999 [6] and has proved to be safe and effective in the early detection of hearing loss after birth [1,2,4,5,6,7], allowing early intervention and improvement of the verbal development in children with congenital hearing loss [1,5,6,7].…”

Section: Introductionmentioning

confidence: 99%

Impact of Gestational Age on Neonatal Hearing Screening in Vaginally-Born Late-Preterm and Early-Term Infants

et al. 2013

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Background: Late-preterm and early-term (LP-ET) infants, defined herein as 35⁰-37⁶ weeks' gestation, often fail on 1st otoacoustic emissions (OAE) test. Hypothesis: LP-ET infants fail more than term infants (38⁰-42 weeks' gestation) on the 1st OAE test. Aim: To evaluate the effect of gestational age on the 1st OAE test. Methods: We studied 1,572 vaginally-delivered (VD) infants ≥35 weeks' gestation (1.1.2011-30.9.2011). Perinatal and neonatal variables and results of OAE tests were recorded. Results: LP-ET infants, compared to full-term infants, had a significantly 2-fold higher need for repeated hearing tests: 80.2 versus 43.3 tests/1,000 neonates, respectively (p = 0.026). Univariate analysis showed that late prematurity and age at 1st OAE were significantly associated with failure on 1st OAE. At age 24-42 h, failure on 1st OAE was 2-fold higher in the LP-ET infants than in full-term infants: 9.4 versus 4.7% (p = 0.02). Risk for failure on 1st OAE was age-dependent: 9-fold higher when 1st OAE was performed at 24-42 h of age (5.3%) versus 0.6% after age 42 h. Multivariate analysis showed that variables that were independently significantly associated with failure on 1st OAE included late prematurity (OR 2.0 (1.1-3.7)) and age at 1st OAE (OR 9.2 (1.2-70.7)). Conclusions: Compared to term infants, VD LP-ET infants had 2-fold higher rates of failure on 1st OAE (up to 42 h of life) and needed repeated hearing tests. Failure rates after 42 h become negligible in both groups. In VD LP-ET infants, 1st OAE is better performed after 42 h of age.

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Ten‐year quality assurance of the nationwide hearing screening programme in Dutch neonatal intensive care units

Abstract: The NHS in Dutch NICUs is effective. Timely identification of hearing loss is improving over time.

Cited by 31 publications

References 18 publications

Hearing Loss by Week of Gestation and Birth Weight in Very Preterm Neonates

Hearing Loss by Week of Gestation and Birth Weight in Very Preterm Neonates

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

Impact of Gestational Age on Neonatal Hearing Screening in Vaginally-Born Late-Preterm and Early-Term Infants

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