title: A comparison of transient-evoked otoacoustic emissions and automated auditory brainstem responses for pre-discharge neonatal hearing screening.
abstract: The aim of this study was to compare two hearing-screening methods in well newborn infants within the postnatal ward environment prior to discharge. Eighty-one newborn infants underwent one-step hearing screening by measurement of automated auditory brainstem responses (aABRs), using the ALGO-3 screener. These were compared with a further cohort of 81 neonates who underwent two-step screening using transient-evoked otoacoustic emissions (TEOAEs) followed by aABR. The pass rate was 78/81 (96.3%) for the one-step screen, 74/81 (91.4%) for the two-step screen, and 54/81 (66.7%) for TEOAE alone. There was no significant difference between cohorts in time required to complete the screening protocol. We conclude that pre-discharge hearing screening of newborn infants on the postnatal ward is feasible and acceptable. Use of TEOAE alone for pre-discharge screening is associated with an excessively high false-positive rate. At our institution, one-step screening resulted in a lower referral rate compared with a two-step approach. The performance of aABR screening may be affected by prior TEOAE screening.
authors.affiliation: Neonatal Intensive Care Unit, Hope Hospital, Salford, UK. paul.clarke@srht.nhs.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Clarke
authors.forename: Mohammed
authors.initials: M
authors.lastname: Iqbal
authors.forename: Simon
authors.initials: S
authors.lastname: Mitchell
mesh_terms: D000367:Age Factors; D015331:Cohort Studies; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis*; D006320:Hearing Tests / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D017084:Otoacoustic Emissions, Spontaneous; D010351:Patient Discharge; D012307:Risk Factors; D012680:Sensitivity and Specificity