title: Evaluating a prediction model for infant hearing loss.
abstract: OBJECTIVE
  The objective of this study was to determine whether a prognostic model using risk factors for hearing loss could predict the chance that infants who failed a newborn hearing screen would subsequently be found to have hearing loss diagnosed by auditory brainstem response testing.
  
  
  METHODS
  Individual retrospective case-control study.
  
  
  METHODS
  We studied 229 infants with hearing loss compared with 458 infants with normal hearing. All infants had undergone natural sleep or sedated auditory brainstem response, predominantly for not passing a newborn hearing screen. Risk factors, birth history, and other information were extracted via medical record review. Multiple logistic regression analyses identified independent predictors of hearing loss.
  
  
  RESULTS
  Four risk factors were independently predictive of hearing loss diagnosed by sleep or sedated auditory brainstem response: prematurity, 5-minute APGAR score ≤ 6, intracranial complication, and craniofacial abnormality. A prognostic model developed from these risk factors was associated with a 15% rate of hearing loss in stage I, 52% rate of hearing loss in stage II, and 96% rate of hearing loss in stage III.
  
  
  CONCLUSIONS
  The presence of any one of four independently predictive risk factors in infants who did not pass newborn hearing screen was associated with a 50% rate of hearing loss; having three or more was associated with a 90% rate of hearing loss. Knowing that an infant is at high risk of hearing loss can motivate parents to follow up with diagnostic auditory brainstem response testing so that early identification can lead to early intervention.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A.
authors.forename: Judith E C
authors.initials: JE
authors.lastname: Lieu
authors.forename: Felicia
authors.initials: F
authors.lastname: Ratnaraj
authors.forename: Banan
authors.initials: B
authors.lastname: Ead
mesh_terms: D016022:Case-Control Studies; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis / Q000453:epidemiology*; D006320:Hearing Tests; D006801:Humans; D007223:Infant; D008297:Male; D015233:Models, Statistical; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Hearing loss; auditory brainstem response; infant; newborn hearing screening; prediction; risk factors