IDENTIFICATION OF NEONATAL HEARING IMPAIRMENT

新生儿听力障碍的识别

• 批准号: 3432993
• 负责人: SUSAN J. NORTON
• 金额: $ 115.45万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-04-01 至 1998-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3432993
• 关键词: audiometry; auditory stimulus; behavior test; diagnosis design /evaluation; diagnosis quality /standard; ear disorder diagnosis; early diagnosis; evoked potentials; health care cost /financing; hearing disorders; human age group; human subject; infant human (0-1 year); longitudinal human study; neurophysiology; newborn human (0-6 weeks); psychoacoustics; stimulus /response

The importance of early intervention to minimize the handicapping effects of hearing impairment makes early diagnosis desirable. Unfortunately, the widespread screening of neonates has been hampered by the lack of sufficiently robust, reliable and cost-effective tools, and by the relatively low prevalence of hearing impairment in this population. The central goat of this multi-center collaborative application is to obtain a large unbiased database containing information about the stimulus-response characteristics of three physiologic responses related to hearing status - transient evoked otoacoustic emissions (TOAE), acoustic distortion product emissions (ADP) and auditory brainstem responses (ABR) - in normal-hearing and hearing-impaired neonates. Four thousand eight hundred (4800) NICU infants and 2400 normal well-baby nursery infants will be evaluated at six sites using ABR, TOAE and ADP. Neonatal hearing status will be validated by behavioral responses to auditory stimuli at 8-12 months corrected age. The accuracy of each tool for identifying neonatal hearing impairment, as validated by visual reinforcement audiometry, will be determined using methods based on signal detection theory. The primary measure of accuracy will be the area under the receiver operating characteristic (ROC) curve. ROC analysis provides a description of disease detectability that is independent from both disuse prevalence and decision threshold effects. These data will be used to design screening protocols with known accuracy and costs as a function of target population and setting. Prototype model systems will be developed and evaluated. Ultimately, these data in concert with modem technology, can be used to design inexpensive, intelligent devices to implement universal screening for hearing impairment. The influence of age and medical status on the performance of TOAE, ADP and ABR in identifying peripheral hearing impairment, as well as the cost of implementation and cost-effectiveness will also be evaluated.

早期干预以最大程度地减少残障效果的重要性 听力障碍使早期诊断可取。 很遗憾， 由于缺乏，新生儿的广泛筛查受到了阻碍 足够健壮，可靠且具有成本效益的工具，并且 该人群中听力障碍的患病率相对较低。 这 此多中心协作应用程序的中心山羊是为了获得 一个大的公正数据库，其中包含有关 三种生理反应相关的刺激反应特征 听力状态 - 短暂诱发的耳声排放（TOAE）， 声学失真产品排放（ADP）和听觉脑干 反应（ABR） - 在正常听力和听力受损的新生儿中。 四个 一千八百（4800）NICU婴儿和2400个正常良好的婴儿 使用ABR，TOAE和ADP，将在六个地点评估苗圃婴儿。 新生儿听力状况将通过行为反应来验证 8-12个月校正年龄的听觉刺激。 每个工具的准确性 用于识别新生儿听力障碍，如视觉验证 强化听力测定法将使用基于基于的方法确定 信号检测理论。 准确性的主要度量将是 接收器操作特征（ROC）曲线下的区域。 鹏 分析提供了疾病可检测性的描述 独立于失败的患病率和决策阈值效应。 这些数据将用于以已知准确性设计筛选协议 成本是目标人群和设置的函数。 原型 模型系统将被开发和评估。最终，这些数据在 与调制解调器技术的音乐会可用于设计廉价的， 智能设备实施通用筛查以进行听力 损害。 年龄和医疗状况对表现的影响 TOAE，ADP和ABR确定外围听力​​障碍，如 而且，实施成本和成本效益也将是 评估。