Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
권호 표지
DOI QR코드

DOI QR Code

Hearing loss screening tool (COBRA score) for newborns in primary care setting

  • Poonual, Watcharapol (Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University) ;
  • Navacharoen, Niramon (Department of Otolaryngology, Faculty of Medicine, Chiang Mai University) ;
  • Kangsanarak, Jaran (Department of Otolaryngology, Faculty of Medicine, Chiang Mai University) ;
  • Namwongprom, Sirianong (Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University) ;
  • Saokaew, Surasak (Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao)
  • Received : 2016.11.25
  • Accepted : 2017.03.31
  • Published : 2017.11.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

Keywords

References

  1. Yoshikawa S, Ikeda K, Kudo T, Kobayashi T. The effects of hypoxia, premature birth, infection, ototoxic drugs, circulatory system and congenital disease on neonatal hearing loss. Auris Nasus Larynx 2004;31:361-8. https://doi.org/10.1016/S0385-8146(04)00115-4
  2. Wroblewska-Seniuk K, Chojnacka K, Pucher B, Szczapa J, Gadzinowski J, Grzegorowski M. The results of newborn hearing screening by means of transient evoked otoacoustic emissions. Int J Pediatr Otorhinolaryngol 2005;69:1351-7. https://doi.org/10.1016/j.ijporl.2005.03.023
  3. Joint Committee on Infant Hearing 1994 Position Statement. American Academy of Pediatrics Joint Committee on Infant Hearing. Pediatrics 1995;95:152-6.
  4. Vatovec J, Velickovic Perat M, Smid L, Gros A. Otoacoustic emissions and auditory assessment in infants at risk for early brain damage. Int J Pediatr Otorhinolaryngol 2001;58:139-45. https://doi.org/10.1016/S0165-5876(01)00419-0
  5. Jariengprasert J. 2003 Universal hearing newborn screening in Ramathibodi hospital. Best Practice in Neonatal Care 2548. p. 323-365
  6. Prasansuk S. Incidence/prevalence of sensorineural hearing impairment in Thailand and Southeast Asia. Audiology 2000;39:207-11. https://doi.org/10.3109/00206090009073080
  7. Thompson DC, McPhillips H, Davis RL, Lieu TL, Homer CJ, Helfand M. Universal newborn hearing screening: summary of evidence. JAMA 2001;286:2000-10. https://doi.org/10.1001/jama.286.16.2000
  8. Mehl AL, Thomson V. The Colorado newborn hearing screening project, 1992-1999: on the threshold of effective population-based universal newborn hearing screening. Pediatrics 2002;109:E7. https://doi.org/10.1542/peds.109.1.e7
  9. Valkama AM, Laitakari KT, Tolonen EU, Vayrynen MR, Vainionpaa LK, Koivisto ME. Prediction of permanent hearing loss in high-risk preterm infants at term age. Eur J Pediatr 2000;159:459-64. https://doi.org/10.1007/s004310051308
  10. Morton CC, Nance WE. Newborn hearing screening--a silent revolution. N Engl J Med 2006;354:2151-64. https://doi.org/10.1056/NEJMra050700
  11. Kochhar A, Hildebrand MS, Smith RJ. Clinical aspects of hereditary hearing loss. Genet Med 2007;9:393-408. https://doi.org/10.1097/GIM.0b013e3180980bd0
  12. American Academy of Pediatrics, Joint Committee on Infant Hearing. Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics 2007;120:898-921. https://doi.org/10.1542/peds.2007-2333
  13. US Preventive Services Task Force. Universal screening for hearing loss in newborns: US Preventive Services Task Force recommendation statement. Pediatrics 2008;122:143-8. https://doi.org/10.1542/peds.2007-2210
  14. Nelson HD, Bougatsos C, Nygren P; 2001 US Preventive Services Task Force. Universal newborn hearing screening: systematic review to update the 2001 US Preventive Services Task Force Recommendation. Pediatrics 2008;122:e266-76. https://doi.org/10.1542/peds.2007-1422
  15. Joint Committee on Infant Hearing; American Academy of Audiology; American Academy of Pediatrics; American Speech-Language- Hearing Association; Directors of Speech and Hearing Programs in State Health and Welfare Agencies. Year 2000 position statement: principles and guidelines for early hearing detection and intervention programs. Joint Committee on Infant Hearing, American Academy of Audiology, American Academy of Pediatrics, American Speech- Language-Hearing Association, and Directors of Speech and Hearing Programs in State Health and Welfare Agencies. Pediatrics 2000;106:798-817. https://doi.org/10.1542/peds.106.4.798
  16. Harrison M, Roush J, Wallace J. Trends in age of identification and intervention in infants with hearing loss. Ear Hear 2003;24:89-95.
  17. Geal-Dor M, Levi H, Elidan Y, Arad I. The hearing screening program for newborns with otoacoustic emission for early detection of hearing loss. Harefuah 2002;141:586-90, 668.
  18. Sun JH, Li J, Huang P, Bu J, Xu ZM, Li J, et al. Early detection of hearing impairment in high-risk infants of NICU. Zhonghua Er Ke Za Zhi 2003;41:357-9.
  19. Khaimook W, Chayarpham S, Dissaneevate S. The high-risk neonatal hearing screening program in Songklanagarind Hospital. J Med Assoc Thai 2008;91:1038-42.
  20. Finckh-Kramer U, Gross M, Bartsch M, Kewitz G, Versmold H, Hess M. Hearing screening of high risk newborn infants. HNO 2000;48:215-20. https://doi.org/10.1007/s001060050035
  21. Hess M, Finckh-Kramer U, Bartsch M, Kewitz G, Versmold H, Gross M. Hearing screening in at-risk neonate cohort. Int J Pediatr Otorhinolaryngol 1998;46:81-9. https://doi.org/10.1016/S0165-5876(98)00151-7
  22. Poonual W, Navacharoen N, Kangsanarak J, Namwongprom S. Risk factors for hearing loss in infants under universal hearing screening program in Northern Thailand. J Multidiscip Healthc 2015;9:1-5.
  23. Harrell F. Regression coefficients and scoring rules. J Clin Epidemiol 1996;49:819.
  24. Moons KG, Harrell FE, Steyerberg EW. Should scoring rules be based on odds ratios or regression coefficients? J Clin Epidemiol 2002;55:1054-5. https://doi.org/10.1016/S0895-4356(02)00453-5
  25. Janssens AC, Deng Y, Borsboom GJ, Eijkemans MJ, Habbema JD, Steyerberg EW. A new logistic regression approach for the evaluation of diagnostic test results. Med Decis Making 2005;25:168-77. https://doi.org/10.1177/0272989X05275154
  26. Leisenring W, Pepe MS. Regression modelling of diagnostic likelihood ratios for the evaluation of medical diagnostic tests. Biometrics 1998;54:444-52. https://doi.org/10.2307/3109754
  27. Vos B, Senterre C, Lagasse R; SurdiScreen Group, Leveque A. Newborn hearing screening programme in Belgium: a consensus recommendation on risk factors. BMC Pediatr 2015;15:160. https://doi.org/10.1186/s12887-015-0479-4
  28. Lieu JE, Ratnaraj F, Ead B. Evaluating a prediction model for infant hearing loss. Laryngoscope 2013;123:2873-9. https://doi.org/10.1002/lary.24033