Rahimi Vida, Mohammadkhani Ghassem, Javadi Farzaneh
Department of Audiology, School of Rehabilitation, Tehran University of Medical Science, Tehran, Iran.
Department of Audiology, School of Rehabilitation, Tehran University of Medical Science, Tehran, Iran.
Int J Pediatr Otorhinolaryngol. 2018 Aug;111:111-114. doi: 10.1016/j.ijporl.2018.06.002. Epub 2018 Jun 5.
One of the most important factors that can improve hearing screening indicators is testing infants after 48 h of birth. The neonatal thyroid screening program is done during the third to fifth day after birth in many countries. So this screening is done at the appropriate time for hearing screening. The aim of the present study was to evaluate hearing screening outcomes (the referral rate, false positive rate, and positive predictive value) conducted with the thyroid screening at the healthcare centers and compare the results with hospital before discharge the infant.
This was a prospective exploratory cohort study. The study population included all the newborns at a hospital (group 1) and newborns who were referred to healthcare centers for thyroid screening (group 2), except for infants with risk factors, from March 2012 to December 2017. Transient evoked otoacoustic emissions (TEOAE) and automatic auditory brainstem response (AABR) were used for the evaluation. The results were compared between the two groups.
Of the 4729 newborns, who participated in the study, 3001 were referred from a hospital (group 1) and 1728 from two healthcare centers (group 2). The referral rate in group 1 and 2 was 16.1% and 7.6%, respectively. Also, the false positive rate in group 1 and 2 was 15.9% and 7.6%, respectively. Our study showed that the referral rate and false positive rate of hearing screening in group 2 were significantly lower than that in group 1 (p < 0.001). The positive predictive value in group 1 was significantly higher than that in group 2 (p < 0.05). There was no significant sex difference in any of the variables.
Our results showed that performing the hearing screening during the thyroid program, instead of the hospital could be significantly improved screening outcomes and suggest that hearing and thyroid screening together after discharge from the hospital could be a good opportunity to introduce new framework for hearing screening in many countries.
能够改善听力筛查指标的最重要因素之一是在婴儿出生48小时后进行检测。在许多国家，新生儿甲状腺筛查项目是在出生后的第三天至第五天进行的。所以这种筛查是在适合进行听力筛查的时间进行的。本研究的目的是评估在医疗保健中心与甲状腺筛查同时进行的听力筛查结果（转诊率、假阳性率和阳性预测值），并将结果与婴儿出院前在医院进行的筛查结果进行比较。
这是一项前瞻性探索性队列研究。研究人群包括2012年3月至2017年12月期间一家医院的所有新生儿（第1组）以及被转诊至医疗保健中心进行甲状腺筛查的新生儿（第2组），但有危险因素的婴儿除外。采用瞬态诱发耳声发射（TEOAE）和自动听性脑干反应（AABR）进行评估。对两组结果进行比较。
参与研究的4729名新生儿中，3001名来自一家医院（第1组），1728名来自两家医疗保健中心（第2组）。第1组和第2组的转诊率分别为16.1%和7.6%。此外，第1组和第2组的假阳性率分别为15.9%和7.6%。我们的研究表明，第2组听力筛查的转诊率和假阳性率显著低于第1组（p<0.001）。第1组的阳性预测值显著高于第2组（p<0.05）。在任何变量中均无显著的性别差异。
我们的结果表明，在甲状腺筛查项目期间进行听力筛查，而非在医院进行，可显著改善筛查结果，并表明在医院出院后同时进行听力和甲状腺筛查可能是许多国家引入听力筛查新框架的一个好机会。
