title: Effectiveness and efficiency of a universal newborn hearing screening in Germany.
abstract: The decision to mandate, finance, and implement a universal newborn hearing screening (UNHS) requires the evaluation of its therapy-directed benefit by comparing (1) a procedure employing a UNHS with (2) a targeted screening for at-risk babies for neonatal hearing disorders and (3) a procedure without systematic screening. In a cohort study the outcome of the UNHS program of Hessen in 2005 with 17,439 screened newborns was analyzed. Validity, effectiveness, and efficiency were evaluated and compared to a sample of 98 Hessian and 355 German children who were detected in 2005 as hearing-impaired but not by an UNHS. The UNHS group had a PASS rate of 97.0%. Forty-nine hearing-impaired children were diagnosed at a median age of 3.1 months and treated at a median age of 3.5 months. Corresponding values for the Hessian non-UNHS group were 17.8 and 21.0 months. For Germany the median age at diagnosis was 39.0 months. The age at therapy onset correlated negatively with parameters of speech/language and psychosocial development. A targeted screening would have resulted in a low sensitivity of 65.3%. Hence, a UNHS is the most effective way to an early therapy of neonatal hearing disorders with an optimal outcome.
authors.affiliation: Clinic of Phoniatrics and Pediatric Audiology, University of Frankfurt/Main, Germany. Katrin.Neumann@em.uni-frankfurt.de
authors.forename: Katrin
authors.initials: K
authors.lastname: Neumann
authors.forename: Manfred
authors.initials: M
authors.lastname: Gross
authors.forename: Peter
authors.initials: P
authors.lastname: Bottcher
authors.forename: Harald A
authors.initials: HA
authors.lastname: Euler
authors.forename: Marlies
authors.initials: M
authors.lastname: Spormann-Lagodzinski
authors.forename: Melanie
authors.initials: M
authors.lastname: Polzer
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004526:Efficiency; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D005858:Germany / Q000453:epidemiology; D034381:Hearing Loss / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000191:economics / Q000379:methods / Q000592:standards*; D017084:Otoacoustic Emissions, Spontaneous; D015397:Program Evaluation / Q000706:statistics & numerical data*; D015203:Reproducibility of Results