Minimizing false-positives in universal newborn hearing screening: a simple solution.

Conrad J Clemens, S. A. Davis

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVES: The false-positive rates of previously reported universal newborn hearing screening (UNHS) programs range between 2.5% and 8%. Critics of UNHS programs have claimed that this rate is too high and might lead to a number of the negative effects produced by false-positive screening tests, namely emotional trauma, disease labeling, iatrogenesis from unnecessary testing, and increased expense in terms of time and money. We previously reported, based on some preliminary data, that as many as 80% of newborns who failed the initial hearing screen subsequently passed when they were retested the following day, before being discharged from the hospital. We now present the results of this intervention for our entire UNHS program during a 7-month period. METHODS: We analyzed data from 3142 non-neonatal intensive care unit infants screened with an automated auditory brainstem response at the Women's Hospital of Greensboro from November 1, 1999 to May 31, 2000. A protocol was developed wherein all infants who failed the initial UNHS were rescreened with another automated auditory brainstem response before hospital discharge. Data collected included pass/fail rates during the inpatient stay as well as follow-up data and risk factors for congenital hearing loss. RESULTS: Confirmed hearing loss occurred in 8 nonneonatal intensive care unit infants, a rate of 2.5/1000. Eighty percent of newborns who failed the initial hearing screen passed on rescreening before hospital discharge. This produced a false-positive rate of 0.8% and a corresponding positive predictive value of 24%. If inhospital rescreening had not occurred, our false-positive rate and positive predictive value would have been 3.9% and 6.1%, respectively. CONCLUSIONS: Our simple intervention of rescreening all infants who failed their initial UNHS before hospital discharge reduced the false-positive rate of UNHS to 0.8%. We suggest that this simple, inexpensive intervention should be instituted for all similar UNHS programs.

Original languageEnglish (US)
JournalPediatrics
Volume107
Issue number3
StatePublished - Mar 2001
Externally publishedYes

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Hearing
Newborn Infant
Brain Stem Auditory Evoked Potentials
Hearing Loss
Intensive Care Units
Inpatients
Wounds and Injuries

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Minimizing false-positives in universal newborn hearing screening : a simple solution. / Clemens, Conrad J; Davis, S. A.

In: Pediatrics, Vol. 107, No. 3, 03.2001.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND AND OBJECTIVES: The false-positive rates of previously reported universal newborn hearing screening (UNHS) programs range between 2.5{\%} and 8{\%}. Critics of UNHS programs have claimed that this rate is too high and might lead to a number of the negative effects produced by false-positive screening tests, namely emotional trauma, disease labeling, iatrogenesis from unnecessary testing, and increased expense in terms of time and money. We previously reported, based on some preliminary data, that as many as 80{\%} of newborns who failed the initial hearing screen subsequently passed when they were retested the following day, before being discharged from the hospital. We now present the results of this intervention for our entire UNHS program during a 7-month period. METHODS: We analyzed data from 3142 non-neonatal intensive care unit infants screened with an automated auditory brainstem response at the Women's Hospital of Greensboro from November 1, 1999 to May 31, 2000. A protocol was developed wherein all infants who failed the initial UNHS were rescreened with another automated auditory brainstem response before hospital discharge. Data collected included pass/fail rates during the inpatient stay as well as follow-up data and risk factors for congenital hearing loss. RESULTS: Confirmed hearing loss occurred in 8 nonneonatal intensive care unit infants, a rate of 2.5/1000. Eighty percent of newborns who failed the initial hearing screen passed on rescreening before hospital discharge. This produced a false-positive rate of 0.8{\%} and a corresponding positive predictive value of 24{\%}. If inhospital rescreening had not occurred, our false-positive rate and positive predictive value would have been 3.9{\%} and 6.1{\%}, respectively. CONCLUSIONS: Our simple intervention of rescreening all infants who failed their initial UNHS before hospital discharge reduced the false-positive rate of UNHS to 0.8{\%}. We suggest that this simple, inexpensive intervention should be instituted for all similar UNHS programs.",
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