Bristow K, Fortnum H, Fonseca S, Bamford J
Institute of Health and Society, Fourth Floor, William Leech Building Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
Arch Dis Child. 2008 Mar;93(3):232-5. doi: 10.1136/adc.2007.126581. Epub 2007 Nov 26.
To determine if the school-entry hearing screening (SEHS) programme continues to make a useful contribution to the identification of childhood hearing impairment in the light of the recent implementation of universal newborn hearing screening, and thereby to inform future policy development.
Postal questionnaire survey to determine current implementation and effectiveness of SEHS SETTING: 244 school health services managed within primary care and acute trusts throughout the UK.
229 SEHS service leads approached; 195 responded.
Details of implementation; positive predictive value of the screening test and its referral criteria.
Implementation of the SEHS is variable, and there is no national approach to data collection, audit and quality assurance. Less than 10% of services had available robust data. The yield from screening ranges from 0.05% to 0.59% for permanent sensorineural hearing impairment and from 0.07% to 0.44% for permanent conductive hearing impairment. The positive predictive values from screen referral vary from 0.62% to 12.16% for permanent sensorineural hearing impairment and 1.24% to 17.56% for permanent conductive hearing impairment.
This comprehensive survey provides a previously unavailable national examination of the SEHS. The few available data on yield indicate that the SEHS may have a small but important role to play in identification of childhood hearing impairment, but the overwhelming conclusion is the urgent need for national guidelines on implementation of this screening programme to determine its value since the implementation nationally of universal newborn hearing screening.
鉴于近期普遍实施了新生儿听力筛查，确定入学听力筛查（SEHS）计划是否继续对儿童听力障碍的识别做出有益贡献，从而为未来的政策制定提供信息。
通过邮寄问卷调查来确定SEHS的当前实施情况和有效性
英国各地初级保健机构和急症信托管理的244所学校卫生服务机构。
联系了229名SEHS服务负责人；195人做出了回应。
实施细节；筛查测试的阳性预测值及其转诊标准。
SEHS的实施情况各不相同，且没有全国统一的数据收集、审计和质量保证方法。不到10%的服务机构有可靠的数据。永久性感音神经性听力障碍的筛查阳性率在0.05%至0.59%之间，永久性传导性听力障碍的筛查阳性率在0.07%至0.44%之间。对于永久性感音神经性听力障碍，筛查转诊的阳性预测值在0.62%至12.16%之间，对于永久性传导性听力障碍，阳性预测值在1.24%至17.56%之间。
这项全面调查提供了此前无法获得的关于SEHS的全国性审视。少数可得的有关阳性率的数据表明，SEHS在识别儿童听力障碍方面可能发挥着虽小但重要的作用，但压倒性的结论是，迫切需要制定关于该筛查计划实施的国家指南，以确定其自全国实施普遍新生儿听力筛查以来的价值。
