Stevens John, Brandreth Marian, Bacon Paul
Department of Medical Physics and Clinical Engineering, Royal Hallamshire Hospital , Sheffield , UK.
Int J Audiol. 2014 Sep;53(9):613-7. doi: 10.3109/14992027.2014.905715. Epub 2014 May 14.
There were two objectives, firstly what effect does a change in the pass criteria of a click-evoked otoacoustic emission (CEOAE) newborn hearing screen have on the number of cases of significant hearing impairment detected by follow up diagnostics, and secondly how does this change affect the screen pass rate?
Changes in the pass criteria were: reduction in the signal-to-noise ratio (SNR); reduction in the minimum signal level (MSL); inclusion of the 1-kHz half-octave band; reduction from two to a single half-octave band.
Data from three screening sites was used within the English newborn hearing screening program from the period 2002 to 2006, with a total number of births of about 40,000. There were 42 bilateral and 43 unilateral cases of significant hearing impairment.
No effect on the number of cases detected by follow up diagnostics was observed when: (1) SNR was reduced to a minimum of 5 dB; (2) MSL was reduced to -10 dB SPL; and (3) the 1-kHz band was included. With all these changes the percentage pass rate improved by 0.36%.
The current choice of SNR and MSL criteria appears robust. Only a small increase in pass rate is possible without affecting case detection.
本研究有两个目的，其一，瞬态诱发耳声发射（CEOAE）新生儿听力筛查的通过标准发生变化，对后续诊断检测出的重度听力障碍病例数量有何影响；其二，这种变化如何影响筛查通过率？
通过标准的变化包括：降低信噪比（SNR）；降低最小信号水平（MSL）；纳入1kHz半倍频程带；从两个半倍频程带减少到一个半倍频程带。
使用了2002年至2006年期间英国新生儿听力筛查项目中三个筛查地点的数据，出生总数约为40000例。有42例双侧和43例单侧重度听力障碍病例。
当出现以下情况时，未观察到对后续诊断检测出的病例数量有影响：（1）SNR降低至最低5dB；（2）MSL降低至-10dB SPL；（3）纳入1kHz频段。所有这些变化使通过率提高了0.36%。
当前SNR和MSL标准的选择似乎很可靠。在不影响病例检测的情况下，通过率仅可能有小幅提高。
