title: Prevalence and referral rates in neonatal hearing screening program using two step hearing screening protocol in Chennai - A prospective study.
abstract: OBJECTIVE
  To estimate the prevalence and referral rates in well born and high risk babies using two step hearing screening protocol with Distortion Product Otoacoustic Emissions (DPOAE) and Automated Auditory Brainstem Response (AABR).
  
  
  METHODS
  A prospective study was carried out on 1405 neonates (983 well born babies and 422 high risk babies) who were screened during May 2013 to January 2015 at Institute of Obstetrics and Gynecology, Madras Medical College, Chennai. All neonates were screened using two step screening protocol. They were initially tested with DPOAE. Referred babies in DPOAE were screened with AABR subsequently.
  
  
  RESULTS
  Among 1405 (100%) neonates 983 (69.96%) were well born babies and 422 (30.03%) were high risk babies. Total referral rate in DPOAE was found to be 311 (22.13%) among which 195 (13.87%) were well born babies and 116 (8.25%) were high risk babies. Out of 311 babies 31 (2.20%) babies were referred in AABR screening. In 31 babies referred in AABR 11(0.78%) were from well born group and 20 (1.42%) were from the high risk group. Further diagnostic evaluation of these babies, 2 (0.14%) were confirmed to have hearing loss. This study reveals, the prevalence of congenital hearing loss in our population is 1.42 per 1000 babies.
  
  
  CONCLUSIONS
  Using two step protocol especially AABR along with DPOAE at the initial level of testing significantly reduces referral rates in new born screening programs. Also AABR decreases the false positive responses hence increasing the efficiency of screening program.
authors: Institute of Speech and Hearing - Upgraded Institute of Otorhinolaryngology, Madras Medical College and Rajiv Gandhi Government General Hospital, EVR Periyar Salai, Chennai 3, India. Electronic address: Vigneshaslp@gmail.com.
authors: S S
authors: SS
authors: Vignesh
authors: Institute of Speech and Hearing - Upgraded Institute of Otorhinolaryngology, Madras Medical College and Rajiv Gandhi Government General Hospital, EVR Periyar Salai, Chennai 3, India. Electronic address: vjayashree70@gmail.com.
authors: V
authors: V
authors: Jaya
authors: Institute of Obstetrics and Gynecology, Government Hospital for Women and Children, Madras Medical College, Panpheon Road, Chennai 8, India. Electronic address: b_i_sasireka@yahoo.com.
authors: B I
authors: BI
authors: Sasireka
authors: Institute of Speech and Hearing - Upgraded Institute of Otorhinolaryngology, Madras Medical College and Rajiv Gandhi Government General Hospital, EVR Periyar Salai, Chennai 3, India. Electronic address: kamalasarathy.audio@gmail.com.
authors: Kamala
authors: K
authors: Sarathy
authors: Institute of Speech and Hearing - Upgraded Institute of Otorhinolaryngology, Madras Medical College and Rajiv Gandhi Government General Hospital, EVR Periyar Salai, Chennai 3, India. Electronic address: vanthanaamo@gmail.com.
authors: M
authors: M
authors: Vanthana
mesh_terms: D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D034381:Hearing Loss / Q000151:congenital / Q000175:diagnosis* / Q000453:epidemiology*; D006320:Hearing Tests; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D017084:Otoacoustic Emissions, Spontaneous; D015995:Prevalence; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*
keywords: Auditory Brainstem Response; Hearing screening; Otoacoustic emissions; Referral rates; Two step protocol