title: Neonatal hearing screening: a combined click evoked and tone burst otoacoustic emission approach.
abstract: OBJECTIVE
  This study evaluated an alternative transient evoked otoacoustic emissions method for screening hearing in newborn babies that may reduce the referral rate of initial screening.
  
  
  METHODS
  A total of 1,033 neonates (2,066 ears) from two hospitals were recruited. Subjects had their hearing screened in both ears using a combined approach-both click evoked OAEs (CEOAEs) and 1kHz tone burst evoked OAEs (TBOAEs).
  
  
  RESULTS
  1kHz TBOAEs were more robust than CEOAEs in terms of emission response level and signal-to-noise ratio (SNR) at both 1 and 1.5kHz frequency bands. The prevalence rate for CEOAE and TBOAE responses in these two frequency bands was significantly different. The combined protocol significantly reduced the referral rate-by almost 2 percentage points for first time screening.
  
  
  CONCLUSIONS
  The implementation of a combined 1kHz TBOAE/CEOAE screening protocol is a feasible and effective way to reduce referral rates, and hence false positive rates, in neonatal hearing screening programs.
authors.affiliation: Centre for Communication Disorders, The University of Hong Kong, Hong Kong SAR, China. weizhang@hkusua.hku.hk
authors.forename: Vicky W
authors.initials: VW
authors.lastname: Zhang
authors.forename: Bradley
authors.initials: B
authors.lastname: McPherson
authors.forename: Bao-Xuan
authors.initials: BX
authors.lastname: Shi
authors.forename: Joyce L F
authors.initials: JL
authors.lastname: Tang
authors.forename: Buddy Y K
authors.initials: BY
authors.lastname: Wong
mesh_terms: D000161:Acoustic Stimulation; D002681:China / Q000453:epidemiology; D003365:Costs and Cost Analysis; D005500:Follow-Up Studies; D006311:Hearing Disorders / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology*; D006320:Hearing Tests / Q000191:economics; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000191:economics; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology*; D015995:Prevalence