title: A new hearing screening system for preschool children.
abstract: OBJECTIVE
  This study aimed to investigate the practical application of Smart Hearing, a new hearing screening system for preschool children.
  
  
  METHODS
  The screening system was applied to 6288 preschool children. The system auto-tested hearing thresholds at three frequencies: 1kHz, 2kHz, and 4kHz; a 30dB hearing level (HL) was the critical intensity for passing. Children with positive results were referred for audiological evaluation (pure tone audiometry, tympanometry and distortion product otoacoustic emissions assessment, etc.). To evaluate the test accuracy, 312 children (5%) were randomly selected to receive audiology assessment.
  
  
  RESULTS
  In this study, 582 children (9.3%) tested positive in the screening, and the referral rate of the four age groups from 3 to 6 years old was 18.8%, 11.9%, 6.5% and 4.0%, respectively. A total of 463 children underwent audiological assessment, of which 12 cases (1.91‰; 95% CI: 0.83‰, 2.99‰) were diagnosed with permanent hearing loss, and 75 cases (1.19%; 95% CI: 0.92%, 1.46%) were diagnosed with temporary conductive hearing loss. No mixed hearing loss was found in this study. The specificity of the system was 92.6% and the sensitivity was only 37.5%.
  
  
  CONCLUSIONS
  This screening system is suitable for the universal hearing screening of preschool children above 4 years old, and further improvements of the system are needed to increase its sensitivity.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China; Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China.
authors.forename: Wenjin
authors.initials: W
authors.lastname: Wu
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China; Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China.
authors.forename: Jingrong
authors.initials: J
authors.lastname: Lü
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China; Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery and Institute of Human Communicative Research, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Anna Chi Shan
authors.initials: AC
authors.lastname: Kam
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery and Institute of Human Communicative Research, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Michael Chi
authors.initials: MC
authors.lastname: Fai Tong
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China; Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China. Electronic address: huangzw086@hotmail.com.
authors.forename: Zhiwu
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China; Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China. Electronic address: ent@xinhua-ent.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis* / Q000453:epidemiology; D006320:Hearing Tests / Q000379:methods; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D012680:Sensitivity and Specificity
keywords: CI; Conductive hearing impairment; HL; Multimedia; OAE; PTA; Permanent hearing impairment; Pure tone screening; confidence interval; dBA; decibels A-weighted; hearing level; otoacoustic emissions; pure tone audiometry