title: Main outcomes of a newborn hearing screening program in Belgium over six years.
abstract: OBJECTIVE
  To present the outcomes of the newborn hearing screening program in Belgium (French-speaking area) since its implementation and to analyze its evolution between 2007 and 2012 in the neonatal population without reported risk factors for hearing loss.
  
  
  METHODS
  The study was descriptive and based on a retrospective analysis of six annual databases (2007-2012) from the newborn hearing screening program. The main outcomes were identified: prevalence of reported hearing impairment; coverage rates (first and second test, follow-up); proportions of conclusive screening tests; referral rate. Each outcome was presented for the six years and by year of birth. Chi-squares were used to study differences in the various outcomes according to time.
  
  
  RESULTS
  Over the six years, 264,508 newborns were considered as eligible for the screening. Hearing impairment was confirmed in 1.41‰ (n = 374) of them, with significant disparities from year to year, between 0.67‰ and 1.94‰. Analysis of the screening process showed that only 92.71% (n = 245,219) of the eligible newborns underwent a first hearing test. This coverage rate varied greatly over time: at the beginning, less than 90% of the newborns had a first test and it rose to almost 95%. After the two screening steps, 2.40% (n = 6340) of the newborns were referred to an ENT doctor; the referral rate slightly decreased during the first years of the program and then stabilized around 2.4%. Over the period, only 62.21% of the referred newborns had a follow-up; the follow-up rate was particularly low for the first year (44.91%) and then strongly increased (+19.52% in 2008) but never exceeded 70%.
  
  
  CONCLUSIONS
  Outcome measures for the newborn hearing screening program in Belgium are lower than the benchmarks released by the Joint Committee on Infant Hearing. Nevertheless, the evolution of the outcome measures since the implementation of the program has been positive, particularly during the first years. At some point, most of the outcome measures decreased or at least did not change any further. The motivation and commitment of the professionals have to be supported in a variety of ways to improve outcome measures and thus, the quality of the program.
authors.affiliation: Université libre de Bruxelles, School of Public Health, Research Center Health Policy and Systems - International Health, Route de Lennik 808, Brussels 1070, Belgium; Centre d'Epidémiologie Périnatale (CEpiP), Route de Lennik 808, Brussels 1070, Belgium. Electronic address: benevos@ulb.ac.be.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Vos
authors.affiliation: Université libre de Bruxelles, School of Public Health, Research Center Health Policy and Systems - International Health, Route de Lennik 808, Brussels 1070, Belgium. Electronic address: rlagass@ulb.ac.be.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Lagasse
authors.affiliation: Université libre de Bruxelles, School of Public Health, Research Center Health Policy and Systems - International Health, Route de Lennik 808, Brussels 1070, Belgium; Centre d'Epidémiologie Périnatale (CEpiP), Route de Lennik 808, Brussels 1070, Belgium; Université libre de Bruxelles, School of Public Health, Research Center Epidemiology, Biostatistic and Clinical Research, Route de Lennik 808, Brussels 1070, Belgium. Electronic address: aleveque@ulb.ac.be.
authors.forename: Alain
authors.initials: A
authors.lastname: Levêque
mesh_terms: D001530:Belgium / Q000453:epidemiology; D005260:Female; D034381:Hearing Loss / Q000453:epidemiology*; D006320:Hearing Tests / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D012017:Referral and Consultation; D012189:Retrospective Studies
keywords: Hearing loss; Newborn hearing screening; Otoacoustic emissions