title: On the threshold of effective well infant nursery hearing screening in Western Sicily.
abstract: OBJECTIVE
  To determine the feasibility and effectiveness of well-infant nursery hearing screening programme for the early identification of hearing impairment, based on transient evoked otoacoustic emission (TEOAE) with a high "screen sensitivity" reducing the number of more expensive secondary level exams.
  
  
  METHODS
  The newborns were screened by non-specialist health workers in well babies nursery at the twentieth day of life for 6 years consecutive. Based on PASS/FAIL criteria and presence/absence of audiological risk factors the newborns were divided into four groups each one with its personal step programme: G1 - PASS without risk factor, free to go home; G2 - PASS with risk factor, retest at the age of 7 months; G3 - FAIL without risk factor, re-screening after 2 weeks for a maximum of four times before audiology assessment; G4 - FAIL with risk factor, retest after 2 weeks.
  
  
  RESULTS
  The coverage rate increased progressively from 89.8% to 92%. The referral rate was 1.51% after second stage with a specificity value of 98.78%. The four-stage screening performed for G3 reduced the numbers of global audiology assessment to 0.91% with a final global specificity of 99.4 ± 0.4%.
  
  
  CONCLUSIONS
  Less than 1% of infants underwent audiological assessment; the false positives resulted 0.62% with hearing loss global incidence of 2.95/1000 and a mean age of confirmation of 3.5 months of age. It is reasonable to think that this screening programme could be implement to overall 42 Western Sicily birth centres within few years.
authors.affiliation: Università degli Studi di Palermo, Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, Sezione di Otorinolaringoiatria, Via del Vespro, 129 - 90127 Palermo, Italy. francescomartines@unipa.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Martines
authors.forename: Daniela
authors.initials: D
authors.lastname: Bentivegna
authors.forename: Simona
authors.initials: S
authors.lastname: Ciprì
authors.forename: Claudio
authors.initials: C
authors.lastname: Costantino
authors.forename: Donatella
authors.initials: D
authors.lastname: Marchese
authors.forename: Enrico
authors.initials: E
authors.lastname: Martines
mesh_terms: D001300:Audiometry, Evoked Response; D002985:Clinical Protocols; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening; D017084:Otoacoustic Emissions, Spontaneous; D011237:Predictive Value of Tests; D012307:Risk Factors; D012802:Sicily