Iley K L, Addis R J
Department of Audiology, York District Hospital, Wigginton Road, York, North Yorkshire, YO3 7HE, UK.
J Perinatol. 2000 Dec;20(8 Pt 2):S122-7. doi: 10.1038/sj.jp.7200443.
To investigate the implications of technology choice between automated auditory brainstem response (AABR) and transiently evoked otoacoustic emissions (TEOAE) on service provision for a universal newborn hearing screening (UNHS) program.
Over a 4-day period, we offered to perform AABR hearing screening on a cohort of 48 well babies in the maternity unit and outpatient department of our busy district hospital. Those parents that consented were asked to sign a consent form and their babies were then screened using the Natus ALGO Model 2e color newborn hearing screener supplied on loan from Neonatal Perspectives Ltd, Manchester, UK. We recorded the patient age at testing, test duration, results obtained (as a pass/refer) and any problems that we experienced with the screening progress, together with parent or user perceived differences between this technology and the current TEOAE screen. A single user carried out all screening. Having collected the AABR data, we then analyzed the implications of the results in relation to service provision in our hospital, utilizing historical data on TEOAE screening.
Forty-four mothers, from 48, consented to having their baby screened by AABR and we were able to achieve a result in all 44 babies that we screened. At the standard test criteria of 35 dBnHL, a total 42 babies passed the initial screen in both ears and 2 referred in a single ear only. The test duration was less than 5 minutes for 36 of 44 babies. Applying these results to a model of UNHS generated a per screen cost of 15.98 Pounds for a two-stage OAE/AABR program and 14.25 Pounds for an AABR-only program. Parents found the AABR test acceptable and we found that being able to discuss the screen and hearing with the parents while the screen was taking place both time-efficient and reassuring to parents. In our experience and using our screening model, the OAE/AABR two-stage approach would have generated 509 infants for second-stage screening (AABR stage) before full audiological follow up and the AABR-only approach would have generated 72 infants for second stage.
Testing with the Natus ALGO Model 2e color newborn hearing screener proved to be practical, time-, and cost-efficient. The low initial referral rate would not only save money within our hospital, but serves to keep parental anxiety at a minimum. The high tolerance of ambient noise allowed flexibility in our screening location and timing, improving our ability to screen before discharge. In our setting, the adoption of AABR as our primary screen is more practical and less expensive than TEOAE.
探讨自动听性脑干反应（AABR）和瞬态诱发耳声发射（TEOAE）之间的技术选择对通用新生儿听力筛查（UNHS）项目服务提供的影响。
在为期4天的时间里，我们主动为繁忙的地区医院产科病房和门诊部的48名健康婴儿进行AABR听力筛查。同意的家长被要求签署一份同意书，然后使用从英国曼彻斯特的新生儿视角有限公司借来的Natus ALGO Model 2e彩色新生儿听力筛查仪对他们的婴儿进行筛查。我们记录了测试时的患者年龄、测试持续时间、获得的结果（通过/转诊）以及筛查过程中遇到的任何问题，以及家长或使用者认为该技术与当前TEOAE筛查之间的差异。由一名使用者进行所有筛查。收集AABR数据后，我们利用TEOAE筛查的历史数据，分析了结果对我院服务提供的影响。
48名母亲中有44名同意对其婴儿进行AABR筛查，我们对所有44名筛查的婴儿都得出了结果。在35 dBnHL的标准测试标准下，共有42名婴儿双耳通过初始筛查，2名仅单耳转诊。44名婴儿中有36名的测试持续时间不到5分钟。将这些结果应用于UNHS模型，两阶段OAE/AABR项目的每次筛查成本为15.98英镑，仅AABR项目为14.25英镑。家长们认为AABR测试是可以接受的，我们发现能够在筛查进行时与家长讨论筛查和听力情况既省时又能让家长放心。根据我们的经验并使用我们的筛查模型，在进行全面听力随访之前，OAE/AABR两阶段方法将产生509名婴儿进行第二阶段筛查（AABR阶段），仅AABR方法将产生72名婴儿进行第二阶段筛查。
使用Natus ALGO Model 2e彩色新生儿听力筛查仪进行测试被证明是实用、省时且经济高效的。较低的初始转诊率不仅能在我院节省资金，还能将家长的焦虑降至最低。对环境噪声的高耐受性使我们在筛查地点和时间安排上具有灵活性，提高了我们在出院前进行筛查的能力。在我们的环境中，采用AABR作为主要筛查方法比TEOAE更实用且成本更低。
