von Kries R, Huisman J J, Bode C, Schmidt E, Willich C, Wirtz P, Ganzer U
Kinderklinik der Heinrich-Heine-Universität, Düsseldorf.
Laryngorhinootologie. 1995 Sep;74(9):543-8.
Assessment of a) the efficacy of hearing loss screening in baby check-ups at the age of 6 to 8 months b) the efficiency and efficacy using parent questionnaires about hearing loss risk factors and parents' concern about the child's hearing as part of baby check-up.
The analyses are based on 7282 baby check-ups carried out in 47 pediatricians' offices in the Düsseldorf area from July 1991 to March 1993: 3385 of these check-ups were performed in the traditional manner (period A; July 1, 1991, to January 1, 1992; 3897 check-ups involved parent questionnaires (period B June 1, 1992, to March 31, 1993). All children who failed the tests and a random sample of those who had passed the test when tested in the traditional manner, were offered extensive hearing assessment.
In period A, 4.3% of the children failed the test as compared to 21.7% with the first version of the questionnaire and 14.3% with a revised questionnaire in period B. Compliance to the offer of extensive hearing assessment was unsatisfactory (53% in period A and 63% in period B). The first extensive hearing examination failed to distinguish healthy children from children with probable sensorineural hearing loss in about 30% of the patients, mainly because of glue ear. One child with sensorineural hearing loss was identified by the screening in period A as compared to six children in period B.
评估a）6至8个月婴儿体检中听力损失筛查的效果；b）在婴儿体检中使用关于听力损失风险因素的家长问卷以及家长对孩子听力的关注程度的效率和效果。
分析基于1991年7月至1993年3月在杜塞尔多夫地区47个儿科诊所进行的7282次婴儿体检：其中3385次体检采用传统方式进行（A期；1991年7月1日至1992年1月1日）；3897次体检涉及家长问卷（B期，1992年6月1日至1993年3月31日）。所有测试未通过的儿童以及在传统方式测试中通过测试的儿童的随机样本，均接受了全面的听力评估。
在A期，4.3%的儿童测试未通过，而在B期，使用第一版问卷时这一比例为21.7%，使用修订版问卷时为14.3%。对全面听力评估提议的依从性不尽人意（A期为53%，B期为63%）。在约30%的患者中，首次全面听力检查未能区分健康儿童与可能患有感音神经性听力损失的儿童，主要原因是中耳积液。A期筛查发现1例感音神经性听力损失儿童，而B期发现6例。
1）在6至8个月婴儿体检中系统使用家长问卷可能会提高筛查效果。2）然而，目前使用的问卷效率需要提高，并且可以利用该研究的数据进行改进。3）必须提高对筛查测试未通过儿童进行全面听力测试的依从性。4）由于该年龄组传导性听力损失的高患病率，在转诊进行感音神经性听力损失的全面测试之前，必须治疗潜在的中耳积液问题。
