Field Sensitivity of Targeted Neonatal Hearing Screening by Transient‐Evoked Otoacoustic Emissions
Field Sensitivity of Targeted Neonatal Hearing Screening by Transient‐Evoked Otoacoustic Emissions
复制标题
通过瞬态诱发耳声发射进行有针对性的新生儿听力筛查的场灵敏度
DOI：
10.1097/00003446-199708000-00001
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发表时间：
1997
期刊：
影响因子：
3.7
通讯作者：
S. Wood
中科院分区：
文献类型：
--
作者：
M. Lutman;A. Davis;H. Fortnum;S. Wood
目的：对双侧中度至重度听力障碍儿童进行人群确定，以确定有多少人通过了基于瞬态诱发耳声发射（TEOAE）的新生儿筛查试验（假阴性），有多少人未通过（真阴性）。设计：从1988年开始，在英国各地的八家医院对新生儿进行了新生儿筛查，使用特制的TEOAE仪器。筛查的目标是有听力障碍风险的新生儿。到1995年年底，共有7500名婴儿接受了检测。在1995年年底完成的各区听力学记录检索中，确定了218名在1988年1月至1993年12月期间出生的儿童，他们的双耳听力阈值水平为50分贝或以上，平均高于0.5、1、2和4千赫的语音频率。其中47例完成了新生儿TEOAE筛查试验。回顾性检查他们的TEOAE记录表明他们是否通过或未通过筛选测试。结果：47人中有11人通过了筛查测试，尽管其中2人在筛查后出现了获得性听力障碍。忽略这两种情况，45例中有9例假阴性，灵敏度估计为80%（36除以45）。在9例病例中，有2例有文献记载的进展证据，其中1例有进行性听力损失的家族史。结论：基于TEOAE的针对性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。假阴性的原因只能靠猜测。可能有以下几种原因：测试可能给出不正确的结果，可能是后来获得的听力障碍，或者可能是原因不明的进行性听力损失。通过新生儿筛查测试并不是放弃进一步监测或无视父母对听力障碍的怀疑的有效理由。
Objective: 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). Design: 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. Results: 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. Conclusions: 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.