与德黑兰医院听觉脑干反应诊断测试相比，新生儿听力筛查中瞬态耳声发射的特异性和敏感性
The specificity and sensitivity of transient otoacustic emission in neonatal hearing screening compared with diagnostic test of auditory brain stem response in tehran hospitals.
作者信息
Yousefi Jaleh, Ajalloueyan Mohammad, Amirsalari Susan, Hassanali Fard Mahdieh
机构信息
New Hearing Technologies Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
出版信息
Iran J Pediatr. 2013 Apr;23(2):199-204.
OBJECTIVE
Since early detection (specially before 6 months of age) of deaf people leads to better hearing and speech outcome after treatment, several clinical trials have been performed in order to find a cost effective, short duration screening test for diagnosis of neonatal hearing impairment. The aim of this study was to assess the sensitivity and specificity of Transient Otoacustic Emission (TEOAE) test in newborns comparing with auditory brain stem response (ABR) in the age of 3 months and to analyze the association between risk factors and hearing loss in neonates.
METHODS
A cross-sectional study was conducted January2008 - May 2009 in Tehran. 1000 newborns (526 boys and 474 girls) were assessed. First, all of neonates were evaluated by TEOAE 24h after birth. If responses of OAE were failing, they were retested 10 to 15 days after birth by TEOAE. Also, All Neonates were assessed by ABR in the age of 3 months. Descriptive Statistics was used to analyze data.
FINDINGS
Eighteen out of 1000 neonates failed double-checked TEOAE tests, of which 6 were confirmed by ABR test (12 false positive results). Nine out of 1000 neonates had impaired ABR tests, from these patients, 6 had failed OAE as well, but 3 had normal OAE (3 false negative results). From these 9 patients 2 had profound hearing loss and received cochlear implantation. We found that OAE has 66.7% sensitivity and 98.8% specificity in diagnosis of neonatal hearing impairment. Its positive and negative predictive value was 33.3% and 99.7% respectively. Also we did not find statistically significant relationship between hearing loss and risk factors.
CONCLUSION
TEOAE as a simple, non-invasive, short duration and cost effective method, is a suitable test for neonatal hearing screening. Even though only two thirds of patients were detected by this method, 99.7% negative predictive value makes it a good screening test. We recommend OAE as a suitable primary neonatal hearing screening all over the country.
目的
由于对聋人的早期检测（特别是在6个月龄之前）会使治疗后的听力和言语结果更好，因此已经进行了多项临床试验，以寻找一种经济高效、短时间的新生儿听力障碍诊断筛查测试。本研究的目的是评估瞬态耳声发射（TEOAE）测试在新生儿中的敏感性和特异性，并与3个月龄时的听性脑干反应（ABR）进行比较，同时分析新生儿危险因素与听力损失之间的关联。
方法
2008年1月至2009年5月在德黑兰进行了一项横断面研究。评估了1000名新生儿（526名男孩和474名女孩）。首先，所有新生儿在出生后24小时通过TEOAE进行评估。如果耳声发射反应未通过，则在出生后10至15天通过TEOAE重新测试。此外，所有新生儿在3个月龄时通过ABR进行评估。使用描述性统计分析数据。
结果
1000名新生儿中有18名经过两次检查的TEOAE测试未通过，其中6名通过ABR测试得到证实（12例假阳性结果）。1000名新生儿中有9名ABR测试受损，在这些患者中，6名耳声发射也未通过，但3名耳声发射正常（3例假阴性结果）。在这9名患者中，2名患有重度听力损失并接受了人工耳蜗植入。我们发现，耳声发射在诊断新生儿听力障碍方面的敏感性为66.7%，特异性为98.8%。其阳性预测值和阴性预测值分别为33.3%和99.7%。此外，我们未发现听力损失与危险因素之间存在统计学上的显著关系。
结论
TEOAE作为一种简单、无创、耗时短且经济高效的方法，是新生儿听力筛查的合适测试。尽管通过这种方法仅检测出三分之二的患者，但99.7%的阴性预测值使其成为一种良好的筛查测试。我们建议在全国范围内将耳声发射作为合适的新生儿听力初筛方法。
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