The false-positive in universal newborn hearing screening
The false-positive in universal newborn hearing screening
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DOI：
10.1542/peds.106.1.e7
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发表时间：
2000-07-01
期刊：
影响因子：
8
通讯作者：
Bailey, AR
中科院分区：
文献类型：
--
作者：
Clemens, CJ;Davis, SA;Bailey, AR
目标.人们对新生儿听力筛查（UNHS）假阳性结果的频率和随后的情绪影响表示担忧。这项研究描述了：1）1个UNHS项目的结果和显著降低假阳性率的潜在方法; 2）假阳性结果对母亲对子女的持久焦虑以及对UNHS的总体看法的影响。回顾性分析使用的数据从5010名婴儿筛选与自动听觉脑干反应（ABR）在格林斯伯勒妇女医院（WHOG）从1998年7月6日至1999年6月30日。此外，对初次听力筛查失败（第1阶段）和完成门诊复查（第2阶段）的婴儿母亲进行了结构化电话调查。非新生儿重症监护室婴儿的确诊听力损失发生率为1.8/1000。在UNHS第1阶段（新生儿出院前筛查），假阳性率为1.9%。我们将这一相对较低的比率归因于出院前未通过初始筛查的新生儿中有51%重新进行了筛查。这些重新筛选的婴儿中有80%通过了，因此不需要额外的随访。如果我们在出院前重新筛查所有婴儿，假阳性率将接近0.5%。关于假阳性测试的持久情绪影响，调查结果令人放心。只有9%的母亲说，在门诊复查之前，她们“对孩子有不同的对待”，只有14%的母亲说，在孩子通过门诊复查后，她们有持续的焦虑。虽然没有达到统计学意义，但持续焦虑的潜在风险因素包括受过更多教育的母亲，缺乏对UNHS的了解，以及第1阶段和第2阶段的假阳性结果。超过90%的母亲认为UNHS是一个好主意。通过在出院前重新筛选所有婴儿，使用自动ABR进行UNHS的假阳性率可以降低到
Objectives. Concern has been raised about the frequency and subsequent emotional effect of a false-positive result during universal newborn hearing screening (UNHS). This study describes: 1) the results of 1 UNHS program and a potential method to significantly reduce the false-positive rate, and 2) the effect a false-positive result has on lasting maternal anxiety toward their children as well as their views toward UNHS in general.Methods. A retrospective analysis was conducted using data from 5010 infants screened with an automated auditory brainstem response (ABR) at the Women's Hospital of Greensboro (WHOG) from July 6, 1998 to June 30, 1999. In addition, a structured telephone survey was given to mothers of infants who had failed the initial hearing screen (stage 1) and who had completed an outpatient rescreen (stage 2).Results. Confirmed hearing loss occurred in nonneonatal intensive care unit infants at a rate of 1.8/1000. A false-positive rate of 1.9% occurred during stage 1 of UNHS (screening before newborn discharge). We attribute this relatively low rate to rescreening of 51% of those newborns who failed the initial screen before hospital discharge. Eighty percent of these rescreened infants passed, thus needing no additional follow-up. If we had rescreened all infants before discharge, the false-positive rate would have approached .5%.Results of the survey were reassuring with regard to lasting emotional effects of false-positive tests. Only 9% of mothers said they "treated their child differently" before outpatient rescreening, and only 14% reported any lasting anxiety after their child passed the outpatient repeat screen. Although none reached statistical significance, potential risk factors for lasting anxiety include more educated mothers, lack of understanding of UNHS, and a false-positive result in both stage 1 and stage 2. Over 90% of all mothers believed that UNHS was a good idea.Conclusions. By rescreening all infants before hospital discharge, the false-positive rate of UNHS performed using automated ABR can be reduced to