title: Hearing screening in the neonatal intensive care unit: follow-up of referrals.
abstract: OBJECTIVE
  The goal of this study was to examine the rate of diagnostic testing after newborn hearing screening (NHS) referral, evaluate timeliness of follow-up, and evaluate the use of multilevel auditory brainstem response (ABR) in screening of high-risk infants.
  
  
  METHODS
  Telephone interviews were conducted with parents of infants who had been admitted to a neonatal intensive care unit from 1999 to 2002 and referred on NHS. An ABR screen was combined with a multilevel ABR (40, 70, and 90 dB nHL) for referrals.
  
  
  RESULTS
  Parents of 206 infants participated; 69% of the infants underwent diagnostic follow-up. Of those with follow-up, 37% had normal hearing, 38% had hearing loss, and parents were unsure of hearing test results for 25%. Follow-up by 6 months of age occurred for 13% in 1999, increasing to 31% by 2002. Infants who did not pass their screening in both ears had confirmed hearing loss in 56% vs. 25% in those who passed in 1 ear. Also, 67% of infants with bilateral pass levels of 90 dB nHL or more had confirmed hearing loss, vs. 32% in all others.
  
  
  CONCLUSIONS
  Timely follow-up after NHS referral in our program has improved over time. Multilevel ABR may facilitate allocation of appropriate resources to track and ensure follow-up in infants at high risk for hearing loss.
authors.affiliation: Washington University School of Medicine, One Children's Place, Room 3S 35, St. Louis, MO 63110, USA. lieuj@ent.wustl.edu
authors.forename: Judith E C
authors.initials: JE
authors.lastname: Lieu
authors.forename: Roanne K
authors.initials: RK
authors.lastname: Karzon
authors.forename: Carole C
authors.initials: CC
authors.lastname: Mange
mesh_terms: D001300:Audiometry, Evoked Response; D003266:Continuity of Patient Care; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007407:Interviews as Topic; D008297:Male; D008923:Missouri; D015997:Neonatal Screening / Q000379:methods*; D010290:Parents / Q000523:psychology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors