The distraction test: The last word?

Russ, Shirley A.; Poulakis, Zeffie; Wake, Melissa; Barker, Melinda; Rickards, Field; Jarman, Frederick; Saunders, Kerryn; Edwards, Gwynne; Symons, Lindsay; Oberklaid, Frank

doi:10.1111/j.1440-1754.2005.00587.x

Cited by 5 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7 Of 45,078 children who passed the distraction test eight were later identified to have a bilateral hearing impairment > 40 dB HL and fitted with hearing aids. The authors report a false-negative rate of 0.02% (8/45,078).…”

Section: False-negative Results From Screening Testsmentioning

confidence: 99%

“…We therefore sought 15 papers 3,7,8,26,[43][44][45][46][47][48][49][50][51][52][53] for full review. All but one 45 (published in 1981) were published between 1996 and 2014.…”

Section: Methodsmentioning

confidence: 99%

“…The universal distraction hearing test, established in the UK in the 1950s and undertaken by health visitors at around 8 months of age, was abandoned following the introduction of UNHS, based on a lack of robust implementation and a low yield of cases. 6,7 Identification of hearing impairment in children in the time between the newborn period and school entry is achieved through parental and professional awareness and a close follow-up of children who pass the neonatal screen but are considered to be at risk. 8 A universal hearing screen when children start school, the school entry screening (SES) programme, was established in 1955 and remains in place in many parts of the UK.…”

Section: Chapter 1 Background and Main Questionsmentioning

confidence: 99%

See 2 more Smart Citations

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

View full text Add to dashboard Cite

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.

show abstract

Section: False-negative Results From Screening Testsmentioning

confidence: 99%

“…We therefore sought 15 papers 3,7,8,26,[43][44][45][46][47][48][49][50][51][52][53] for full review. All but one 45 (published in 1981) were published between 1996 and 2014.…”

Section: Methodsmentioning

confidence: 99%

Section: Chapter 1 Background and Main Questionsmentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

show abstract

“…17 , 2000, BAROCH 5 , 2003, NG et al 27 , 2004, STOOL 35 , 200435 , , HYDE 18 , 2005. Assim todas as etapas de um programa de saúde auditiva devem estar bem definidas e articuladas entre si, garantindo sua eficácia (RUSS et al 34 , 2004, RIBEIRO 33 , 200533 , , HYDE 18 , 2005.…”

Section: -Identificação De Estratégias De Orientação Fonoaudiológica unclassified

“…Os autores sugerem, ainda, que outros estudos sejam realizados a fim de se determinar um protocolo de triagem auditiva neonatal ideal. Esses estudos devem ter como objetivo: o custo da triagem, assim como o custo do equipamento, dos materiais descartáveis, dos profissionais, da administração, e dos testes de continuação; além de verificar a eficácia de outras ferramentas e protocolos dos programas de triagem auditiva neonatal e a ansiedade dos pais causada por resultados falso-positivos.Para analisar a relevância da triagem auditiva neonatal realizada por meio do potencial evocado, RUSS et al34 , 2004, aplicaram um questionário a pais de bebês deficientes auditivas usuárias de dispositivo eletrônico e que passaram pela triagem. Do total de participantes, 61% revelaram experiências emocionais frente à TANU tais como: negação, choque, frustração em relação ao atraso do diagnóstico, confusão para entender sobre a audição, dificuldades em entender o dispositivo eletrônico, dificuldades enfrentadas pela criança na inclusão social.…”

unclassified

Intervenção fonoaudiológica junto à família durante um programa de triagem auditiva neonatal universal

Vitti¹

View full text Add to dashboard Cite

Alvarenga, pelas valiosas sugestões apresentadas na banca de qualificação. Aos autores pesquisadores sobre o tema: preocupação familiar frente à triagem auditiva, que prontamente responderam aos meus e-mails, em especial à M.D. PhD. Betty Vohr, PhD. Leif Hergils e PhD Åsa Hergils, por terem enviado os questionários e autorizado a aplicação dos mesmos, viabilizando esse estudo. Às minhas amigas da 1ª turma de Mestrado em Fonoaudiologia FOB-USP, alegremente agradeço, pelo companheirismo de todas e que fizeram deste programa de pós-graduação um ótimo lugar para estar. Aos professores do Programa de Pós-Graduação do Mestrado em Fonoaudiologia por terem acreditado no meu potencial.

show abstract

Child health and development

Ellis¹

2011

General Practice

View full text Add to dashboard Cite

The distraction test: The last word?

Cited by 5 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

Intervenção fonoaudiológica junto à família durante um programa de triagem auditiva neonatal universal

Child health and development

Contact Info

Product

Resources

About