Thangavelu Kruthika, Martakis Kyriakos, Feldmann Silke, Roth Bernhard, Herkenrath Peter, Lang-Roth Ruth
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, Germany.
Department of Pediatric Neurology, Social Pediatrics and Epileptology, Justus-Liebig-University Giessen and University Hospital Marburg Giessen, Feulgenstrasse 10-12, 35392 Giessen, Germany.
Int J Neonatal Screen. 2023 Oct 23;9(4):61. doi: 10.3390/ijns9040061.
Regular reporting of quality control is important in newborn hearing screening, ensuring early diagnosis and intervention. This study reports on a population-based newborn hearing screening program in North-Rhine, Germany and a hospital-based screening at a University Hospital for 2007-2016. The two-staged 'screening' and 'follow-up' program involving TEOAE and AABR recruited newborns through participating birth facilities. Results were sent to the regional tracking center, and the data were analyzed based on recommended benchmarks. The percentage of newborns from the participating birth facilities in the region increased from 1.4% in 2007 to 57.5% in 2016. The 10-year coverage rate for these newborns was 98.7%, the referral rate after a failed two-step screening was 3.4%, and the lost-to-follow-up rate was 1%. At the hospital, >95% of the screened newborns completed screening within 30 days, the 10-year referral rate was 5%, and 64% were referred within 3 months of age. The median time for screening completion was 6 days after birth, for referral it was 74 days after birth, and for diagnosis it was 55 days after birth. Regional-centralized tracking centers with uniform structure are necessary for proper quality control. Obligatory participation of birthing facilities and quality reports may improve performance, but the recommended quality criteria need considerable financial and infrastructural expenditure.
定期报告质量控制在新生儿听力筛查中很重要，可确保早期诊断和干预。本研究报告了德国北莱茵地区一项基于人群的新生儿听力筛查项目以及一所大学医院在2007年至2016年期间开展的基于医院的筛查。这个分两阶段的“筛查”和“随访”项目采用瞬态诱发耳声发射（TEOAE）和自动听性脑干反应（AABR），通过参与的分娩机构招募新生儿。结果被发送到区域追踪中心，并根据推荐的基准对数据进行分析。该地区参与分娩机构的新生儿比例从2007年的1.4%增至2016年的57.5%。这些新生儿的10年覆盖率为98.7%，两步筛查未通过后的转诊率为3.4%，失访率为1%。在医院，>95%的筛查新生儿在30天内完成筛查，10年转诊率为5%，64%在3个月龄内被转诊。筛查完成的中位时间为出生后6天，转诊为出生后74天，诊断为出生后55天。结构统一的区域集中追踪中心对于适当的质量控制是必要的。分娩机构的强制参与和质量报告可能会提高绩效，但推荐的质量标准需要大量的资金和基础设施支出。
