Population outcomes of three approaches to detection of congenital hearing loss

Wake, Melissa, Ching, Teresa Y.C., Wirth, Karen, Poulakis, Zeffie, Mensah, Fiona K., Gold, Lisa, King, Alison, Bryson, Hannah E., Reilly, Sheena and Rickards, Field 2016, Population outcomes of three approaches to detection of congenital hearing loss, Pediatrics, vol. 137, no. 1, Article number : e20151722, pp. 1-12, doi: 10.1542/peds.2015-1722.

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Title Population outcomes of three approaches to detection of congenital hearing loss
Author(s) Wake, Melissa
Ching, Teresa Y.C.
Wirth, Karen
Poulakis, Zeffie
Mensah, Fiona K.
Gold, LisaORCID iD for Gold, Lisa orcid.org/0000-0002-2733-900X
King, Alison
Bryson, Hannah E.
Reilly, Sheena
Rickards, Field
Journal name Pediatrics
Volume number 137
Issue number 1
Season Article number : e20151722
Start page 1
End page 12
Total pages 12
Publisher American Academy of Pediatrics
Place of publication Evanston, Ill.
Publication date 2016-01
ISSN 1098-4275
Keyword(s) Australia
Child, Preschool
Cost-Benefit Analysis
Hearing Disorders
Infant, Newborn
Neonatal Screening
Risk Assessment
Risk Factors
Science & Technology
Life Sciences & Biomedicine
Summary BACKGROUND: Universal newborn hearing screening was implemented worldwide largely on modeled, not measured, long-term benefits. Comparative quantification of population benefits would justify its high cost.

METHODS: Natural experiment comparing 3 population approaches to detecting bilateral congenital hearing loss (>25 dB, better ear) in Australian states with similar demographics and services: (1) universal newborn hearing screening, New South Wales 2003-2005, n = 69; (2) Risk factor screening (neonatal intensive care screening + universal risk factor referral), Victoria 2003-2005, n = 65; and (3) largely opportunistic detection, Victoria 1991-1993, n = 86. Children in (1) and (2) were followed at age 5 to 6 years and in (3) at 7 to 8 years. Outcomes were compared between states using adjusted linear regression.

RESULTS: Children were diagnosed younger with universal than risk factor screening (adjusted mean difference -8.0 months, 95% confidence interval -12.3 to -3.7). For children without intellectual disability, moving from opportunistic to risk factor to universal screening incrementally improved age of diagnosis (22.5 vs 16.2 vs 8.1 months, P < .001), receptive (81.8 vs 83.0 vs 88.9, P = .05) and expressive (74.9 vs 80.7 vs 89.3, P < .001) language and receptive vocabulary (79.4 vs 83.8 vs 91.5, P < .001); these nonetheless remained well short of cognition (mean 103.4, SD 15.2). Behavior and health-related quality of life were unaffected.

CONCLUSIONS: With new randomized trials unlikely, this may represent the most definitive population-based evidence supporting universal newborn hearing screening. Although outperforming risk factor screening, school entry language still lagged cognitive abilities by nearly a SD. Prompt intervention and efficacy research are needed for children to reach their potential.
Language eng
DOI 10.1542/peds.2015-1722
Field of Research 11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Socio Economic Objective 920599 Specific Population Health (excl. Indigenous Health) not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, American Academy of Pediatrics
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080980

Document type: Journal Article
Collections: Faculty of Health
School of Health and Social Development
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