Hearing screening in newborns: systematic review of accuracy, effectiveness, and effects of interventions after screening
- 1Department of Medical Biometry and Statistics, University Hospital Freiburg, Freiburg, Germany
- 2Kleijnen Systematic Reviews Ltd, York, UK
- 3Institute for Quality and Efficiency in Health Care, Cologne, Germany
- 4Care and Public Health Research Institute (CAPHRI), University of Maastricht, Maastricht, the Netherlands
- Correspondence to Robert Wolff, Kleijnen Systematic Reviews Ltd, Westminster Business Centre, 10 Great North Way, Nether Poppleton, York YO26 6RB, UK;
Author contributions All authors had full access to all of the data and take responsibility for the integrity and accuracy of the data. Project proposal and acquiring funding: GA and JK; study concept and design: SL and JK; data extraction: RW, JH, RR and JK; data analysis: all authors; drafting the manuscript: RW and JK; commenting on manuscript: all authors.
- Accepted 23 February 2009
- Published Online First 26 March 2009
Background The authors aimed to evaluate the benefits and harms of universal newborn hearing screening programmes in the detection of hearing impairment.
Objectives In the absence of randomised trials evaluating whole screening programmes, the study divided the objective into three systematic reviews of non-randomised controlled studies of diagnostic accuracy of screening tests, screening versus no screening, and therapeutic effect of early versus later treatment.
Methods The authors searched 11 bibliographic databases, and included 17 studies (diagnostic: 9, screening: 2, and treatment: 6). All studies apart from one treatment study showed major quality deficits. Eight diagnostic studies comparing otoacoustic emissions with auditory brainstem response showed sensitivities (and specificities) between 50% (49.1%) and 100% (97.2%).
Results The studies comparing screening versus no screening showed an improvement of speech development of children in the screening group compared with the group without screening. Early treatment was associated with better language development in comparison to children with later treatment.
Conclusions The authors concluded that there is a lack of high-quality evidence regarding all elements of newborn hearing screening. Early identification and early treatment of children with hearing impairments may be associated with advantages in language development. Other patient-relevant parameters, such as social aspects, quality of life, and educational development, have not been adequately investigated.
Funding The project was commissioned by the Federal Joint Committee (Gemeinsamer Bundesausschuss, Auf dem Seidenberg 3a, 53721 Siegburg Germany) to the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG, Dillenburger Str. 27, 51105 Cologne, Germany). IQWiG has final responsibility for the original report and funded all authors to participate in the project.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.