Inventory of current EU paediatric vision and hearing screening programmes.
OBJECTIVE
To examine the diversity in paediatric vision and hearing screening programmes in Europe.


METHODS
Themes for comparison of screening programmes derived from literature were used to compile three questionnaires on vision, hearing, and public health screening. Tests used, professions involved, age, and frequency of testing seem to influence sensitivity, specificity, and costs most. Questionnaires were sent to ophthalmologists, orthoptists, otolaryngologists, and audiologists involved in paediatric screening in all EU full-member, candidate, and associate states. Answers were cross-checked.


RESULTS
Thirty-nine countries participated; 35 have a vision screening programme, 33 a nation-wide neonatal hearing screening programme. Visual acuity (VA) is measured in 35 countries, in 71% of these more than once. First measurement of VA varies from three to seven years of age, but is usually before age five. At age three and four, picture charts, including Lea Hyvarinen, are used most; in children over four, Tumbling-E and Snellen. As first hearing screening test, otoacoustic emission is used most in healthy neonates, and auditory brainstem response in premature newborns. The majority of hearing testing programmes are staged; children are referred after 1-4 abnormal tests. Vision screening is performed mostly by paediatricians, ophthalmologists, or nurses. Funding is mostly by health insurance or state. Coverage was reported as >95% in half of countries, but reporting was often not first-hand.


CONCLUSIONS
Largest differences were found in VA charts used (12), professions involved in vision screening (10), number of hearing screening tests before referral (1-4), and funding sources (8).
Department of Ophthalmology, Erasmus University Medical Center Rotterdam, the Netherlands f.sloot@erasmusmc.nl.
Frea
F
Sloot
Department of Otorhinolaryngology, Erasmus University Medical Center Rotterdam, the Netherlands.
Hans L J
HL
Hoeve
Department of Public Health, Erasmus University Medical Center Rotterdam, the Netherlands.
Marlou L A
ML
de Kroon
Department of Otorhinolaryngology, Erasmus University Medical Center Rotterdam, the Netherlands.
André
A
Goedegebure
Health Economics and Decision Science (HEDS), School of Health and Related Research (ScHARR), University of Sheffield, UK.
Jill
J
Carlton
Academic Unit of Ophthalmology & Orthoptics, University of Sheffield, UK.
Helen J
HJ
Griffiths
Department of Ophthalmology, Erasmus University Medical Center Rotterdam, the Netherlands.
Huibert J
HJ
Simonsz
D002648:Child; D002675:Child, Preschool; D005062:European Union; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D006320:Hearing Tests / Q000191:economics; D006801:Humans; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology; D011634:Public Health; D015351:Vision Screening; D014792:Visual Acuity
EU; hearing; paediatric; prevention; screening; vision