[Hearing screening in newborn infants. Comparative studies and cost analysis with different instruments].
BACKGROUND
The necessity of screening examinations in newborns today cannot be denied. Up to now, it has only been achieved in a few countries to introduce a general hearing screening for newborns.


METHODS
We examined 100 newborns (200 ears) at their third day of life. All ears were evaluated with the TEOAE-screening-device ECHOSCREEN. In addition, we carried out BERA screening examinations with the ALGO PORTABLE or with the EVOFLASH on 100 of these 200 ears. As a reference method, we utilized TEOAE-examinations with the ILO-88 for all ears.


RESULTS
4.5% of the 200 ears examined with the ECHOSCREEN were conspicuous due to accumulation of earwax problems. With the ALGO-system, none of the ears was conspicuous. Among the 100 ears examined with the EVOFLASH we found negative results with seven ears (4 children). These findings will be discussed in detail. Furthermore, we analyzed the costs for one-step- and two-step-screenings. Costs for a one-step-screening of both ears would be DM 14.27 with Echoscreen, DM 44.69 with ALGO, DM 32.19 with Evoflash for one patient including material and personnel costs. Costs for a two-step-screening would be DM 16.28 with Echoscreen and ALGO, DM 15.72 with Echoscreen and Evoflash, calculated per child on the basis of 812,173 newborn children in the year 1997 in Germany.


CONCLUSIONS
On the basis of all these results, we recommend a two-step-screening with TEOAE and BERA-devices.
Heinemann
M
M
Klinik für Kommunikationsstörungen, Johannes Gutenberg-Universität Mainz.
Bohnert
A
A
D001300:Audiometry, Evoked Response / Q000191:economics / Q000295:instrumentation*; D003055:Cochlear Microphonic Potentials / Q000502:physiology*; D003362:Cost-Benefit Analysis; D003638:Deafness / Q000175:diagnosis / Q000191:economics* / Q000209:etiology; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000191:economics / Q000295:instrumentation*; D011237:Predictive Value of Tests; D012016:Reference Values; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*