title: Comparison of screening methods for conductive hearing loss identification in children: low-cost proposal.
abstract: OBJECTIVE
  To evaluate the effectiveness of two screening methods (imitanciometry screening and questionnaire) to identify children at risk for conductive hearing loss, comparing this data with complete audiologic evaluation.
  
  
  METHODS
  Of 507 children aged between three and six, 111 completed all procedures. The observational methods used were: imitanciometry screening, a questionnaire to identify risk factors for hearing loss and complete audiologic evaluation. Results obtained in the first two instruments were compared with results from complete audiologic evaluation (gold standard). From these comparisons, sensitivity and specificity, accuracy, positive and negative predictive values, and odds ratio were determined for the two screening methods and for the combination of both methods.
  
  
  RESULTS
  The two methods applied in series (questionnaire and after imitanciometry screening) showed a greater odds ratio and better correlation between sensitivity and proportion of false-positives (ROC curve).
  
  
  CONCLUSIONS
  Combining the two tests in series improved screening accuracy. This combination was the best tool for identifying children at risk for conductive hearing loss.
authors.affiliation: Department of Physical Therapy, Speech-language Pathology and Audiology, and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil. alesamelli@usp.br
authors.forename: A G
authors.initials: AG
authors.lastname: Samelli
authors.forename: C M
authors.initials: CM
authors.lastname: Rabelo
authors.forename: M B
authors.initials: MB
authors.lastname: Pereira
authors.forename: M N
authors.initials: MN
authors.lastname: Portela
authors.forename: S G G
authors.initials: SG
authors.lastname: Sanches
authors.forename: I F
authors.initials: IF
authors.lastname: Neves-Lobo
mesh_terms: D017668:Age of Onset; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003939:Diagnostic Techniques, Otological / Q000191:economics / Q000295:instrumentation; D005260:Female; D006314:Hearing Loss, Conductive / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D015995:Prevalence; D012107:Research Design; D011795:Surveys and Questionnaires