Mohan B Meghana, Jain Chandni
All India Institute of Speech and Hearing, Naimisham campus, Manasagangothri, Mysore, 570006, India.
Eur Arch Otorhinolaryngol. 2025 Apr;282(4):1843-1851. doi: 10.1007/s00405-024-09085-y. Epub 2024 Nov 28.
Our study aimed to assess the reliability of screening tests in healthy newborns across diverse hospital environments and neonatal intensive care unit (NICU) infants hospitalized for over 5 days, particularly within the framework of hearing screening in developing countries.
The study comprised 100 neonates in each group: G1 (healthy infants in government general wards), G2 (healthy infants in private special wards), and G3 (infants in NICU for over 5 days). Intra-session (within 5 min) and inter-session (within a month) otoacoustic emissions (OAE) and automated auditory brainstem responses (AABR) recordings were conducted and the reliability of each test was evaluated across sessions and groups.
The weighted Kappa results showed poor within-session reliability of OAEs in G1 and G3, while G2 exhibited good reliability. AABR intra-session reliability was consistently good across all three groups. The inter-session reliability of OAEs remained poor in G1 and G3 but better in G2. Significantly, the inter-session reliability for AABR decreased in G1 and G3, with Chi-square analysis revealing a notable referral discrepancy between the initial and final assessments. Such a disparity was absent in G2, where reliability remained high.
The study highlights the compromised reliability of OAEs in noisy environments, while AABR maintains good reliability under similar conditions. Additionally, AABR shows poorer reliability when conducted within a specific early timeframe, emphasizing the importance of screening after this period. This issue does not affect OAE, but OAE is limited in detecting mild conductive components. The study highlights the poor reliability of AABRs in the NICU group, attributing this to the potential for improved thresholds over time within this group.
我们的研究旨在评估在不同医院环境下对健康新生儿以及住院超过5天的新生儿重症监护病房（NICU）婴儿进行筛查测试的可靠性，特别是在发展中国家听力筛查的框架内。
该研究每组包括100名新生儿：G1组（政府普通病房中的健康婴儿）、G2组（私立特殊病房中的健康婴儿）和G3组（在NICU住院超过5天的婴儿）。进行了会话内（5分钟内）和会话间（一个月内）的耳声发射（OAE）和自动听性脑干反应（AABR）记录，并在各会话和组间评估了每项测试的可靠性。
加权Kappa结果显示，G1组和G3组中OAE的会话内可靠性较差，而G2组表现出良好的可靠性。所有三组中AABR的会话内可靠性始终良好。G1组和G3组中OAE的会话间可靠性仍然较差，但G2组更好。值得注意的是，G1组和G3组中AABR的会话间可靠性下降，卡方分析显示初始评估和最终评估之间存在明显的转诊差异。G2组不存在这种差异，其可靠性仍然很高。
该研究强调了在嘈杂环境中OAE的可靠性受损，而AABR在类似条件下保持良好的可靠性。此外，在特定的早期时间范围内进行AABR时，其可靠性较差，强调了在此时间段之后进行筛查的重要性。这个问题不会影响OAE，但OAE在检测轻度传导成分方面存在局限性。该研究强调了NICU组中AABR的可靠性较差，将其归因于该组随着时间推移阈值可能提高。
