Lutman M E, Davis A C, Fortnum H M, Wood S
Medical Research Council's Institute of Hearing Research, Nottingham, UK.
Ear Hear. 1997 Aug;18(4):265-76. doi: 10.1097/00003446-199708000-00001.
Population ascertainment of children having bilateral moderate to profound hearing impairment was undertaken to find out how many had passed (false negatives) and how many had failed (true negatives) a neonatal screening test based on transient-evoked otoacoustic emissions (TEOAE).
Neonatal screening using a purpose-built TEOAE instrument was undertaken in neonates, at eight hospitals in districts distributed around the United Kingdom starting in 1988. Screening was targeted on neonates at risk of hearing impairment. A total of 7500 babies had been tested by the end of 1995. Searching of audiological records in the districts completed at the end of 1995 ascertained 218 children born between January 1988 and December 1993 who had hearing threshold levels in both ears of 50 dB or more, averaged over the speech frequencies 0.5, 1, 2, and 4 kHz. Of those, 47 had completed the neonatal TEOAE screening test. Retrospective examination of their TEOAE records indicated whether they had passed or failed the screening test.
Eleven of the 47 had passed the screening test, although two of those had documented acquired hearing impairment occurring after screening. Disregarding those two cases leaves nine false negatives out of 45, giving a sensitivity estimate of 80% (36 divided by 45). In two of the nine cases, there was documented evidence of progression, one of whom had a family history of progressive hearing loss.
Targeted neonatal hearing screening programs based on TEOAE can expect to identify hearing impairment in approximately 80% of babies screened. The cause of false negatives is a matter for conjecture. There may be several reasons: the test may give an incorrect result, there may be a later acquired hearing impairment, or there may be a progressive hearing loss of unknown origin. Passing a neonatal screening test is not a valid reason to forego further surveillance, or to disregard parental suspicion of hearing impairment.
对患有双侧中度至重度听力障碍的儿童进行群体确定，以查明基于瞬态诱发耳声发射（TEOAE）的新生儿筛查试验中有多少儿童筛查通过（假阴性）以及有多少儿童筛查未通过（真阴性）。
从1988年开始，在英国各地分布的八个地区的医院，对新生儿使用专门构建的TEOAE仪器进行新生儿筛查。筛查针对有听力障碍风险的新生儿。到1995年底，共有7500名婴儿接受了检测。在1995年底完成了对各地区听力记录的检索，确定了1988年1月至1993年12月期间出生的218名儿童，他们在0.5、1、2和4千赫语音频率上双耳平均听力阈值水平为50分贝或更高。其中，47名儿童完成了新生儿TEOAE筛查试验。对他们的TEOAE记录进行回顾性检查，以表明他们的筛查试验是否通过。
47名儿童中有11名筛查通过，尽管其中两名儿童有记录表明在筛查后出现了获得性听力障碍。不考虑这两个病例，45名儿童中有9例假阴性，敏感性估计为80%（36除以45）。在这9例中的2例中，有记录的病情进展证据，其中1例有进行性听力损失家族史。
基于TEOAE的有针对性的新生儿听力筛查项目有望在大约80%的筛查婴儿中识别出听力障碍。假阴性的原因尚属推测。可能有几个原因：测试可能给出错误结果，可能有后来获得性听力障碍，或者可能有不明原因的进行性听力损失。通过新生儿筛查试验并不是放弃进一步监测或忽视家长对听力障碍怀疑的正当理由。
