Uus Kai, Bamford John
Audiology and Deafness Research Group, School of Psychological Sciences, Faculty of Medical and Human Sciences, University of Manchester, Manchester, United Kingdom.
Pediatrics. 2006 May;117(5):e887-93. doi: 10.1542/peds.2005-1064.
The objective of this study was to determine the effectiveness in routine practice of the first phase of a national population-based newborn hearing screening and follow-up program that seeks to identify infants with bilateral permanent hearing loss of > or =40-dB hearing loss.
The study was a part of the independent evaluation of the 23 first phase sites (annual birth population approximately 120,000) of the national newborn hearing screening program in England. For each infant identified with the defined hearing loss, the measures of interest were degree and type of hearing loss, presence of risk factors, age of first audiologic assessment, age of identification of hearing loss, age of enrollment in an early support program, and age of hearing aid fitting. Data collection took place over the first 2 years of the program.
Data were provided on 169 infants with permanent bilateral moderate or greater hearing loss identified through screening 169487 infants. Fifty-four percent of all cases were from an "at-risk" population. Three fourths of these "at-risk" infants spent > or =48 hours in the NICU. For the whole sample, the median age at first audiologic assessment was 5 weeks; the median age of identification of the hearing loss and of enrollment in early support program was 10 weeks irrespective of the degree of hearing loss; and the median age at hearing aid fitting was 16 weeks. Infants with moderate hearing loss were fitted with hearing aids significantly later than those with severe and profound hearing loss.
Properly implemented, a newborn hearing screening program based on whole populations and routine service provision can deliver satisfactory outcomes in terms of age of referral, identification, and intervention. The distribution of degree and type of hearing loss and proportion with risk factors was similar to that expected. The numbers identified were such as to suggest that very few cases were missed by the screening program.
本研究的目的是确定一项全国性基于人群的新生儿听力筛查及随访项目第一阶段在常规实践中的有效性，该项目旨在识别双侧永久性听力损失≥40分贝的婴儿。
本研究是对英格兰全国新生儿听力筛查项目的23个第一阶段站点（年出生人口约120,000）进行独立评估的一部分。对于每例确诊为规定听力损失的婴儿，关注的指标包括听力损失的程度和类型、危险因素的存在情况、首次听力评估的年龄、听力损失确诊的年龄、参加早期支持项目的年龄以及佩戴助听器的年龄。数据收集在该项目的前两年进行。
在筛查的169487例婴儿中，提供了169例双侧永久性中度或更严重听力损失婴儿的数据。所有病例的54%来自“高危”人群。这些“高危”婴儿中有四分之三在新生儿重症监护病房（NICU）度过≥48小时。对于整个样本，首次听力评估的中位年龄为5周；听力损失确诊和参加早期支持项目的中位年龄均为10周，与听力损失程度无关；佩戴助听器的中位年龄为16周。中度听力损失的婴儿佩戴助听器的时间明显晚于重度和极重度听力损失的婴儿。
基于全体人群并通过常规服务提供来实施的新生儿听力筛查项目，在转诊、确诊和干预年龄方面能够取得令人满意的结果。听力损失的程度和类型分布以及有危险因素的比例与预期相似。筛查出的病例数量表明，该筛查项目极少漏诊病例。
