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Pediatrics (P)

PP1113 - Implications of Newborn Hearing Screening Protocols

POSTERS
Location: Halls A1-A2
Instructional Level: Intermediate
Abstract: This study compares the outcomes of a rural remote and traditional ABR program at a pediatric clinic in Houston, Texas, to examine why results vary between the two programs. The patients’ newborn hearing screening methodologies will be analyzed to conclude if protocols utilized by hospitals referring to the remote ABR program differ in specificity compared to those that refer to the primary clinic location.  The purpose of this research is to determine why a significant number of referrals to the remote clinic result in typical hearing thresholds compared to the cases of hearing loss diagnosed at the primary location.

Summary: The purpose of this study is to determine how newborn hearing screening (NBHS) protocols impact the results of diagnostic testing. A remote Auditory Brainstem Response (ABR) program located 3 hours north of Houston, Texas, was created by a pediatric facility to strategically target patients in a rural area with an elevated loss-to-follow-up/documentation (LFU/LTD) rate. An increased number of normal hearing ABR results have been identified at the remote site when compared to the results of ABRs performed at the traditional site. To examine the data, all patients seen through the remote and traditional ABR clinic sites will be studied beginning with the launch date of the remote ABR program. Demographic patient data will be collected and analyzed to include: name, birthing hospital location, date of birth, zip code, and type of hospital stay (e.g. NICU or well-baby nursery). Newborn hearing screening data, including the number of inpatient and outpatient screenings, the type of screening utilized, and the outcomes of both the screenings for the left ear and right ear (collected from the Texas Early Hearing Detection and Early Intervention (TEHDI) database) and the test results of the diagnostic ABR will also be collected. The results of the diagnostic ABR will be analyzed along with the age at the initial ABR, the date of the ABR, and the site at which the ABR was completed. Next, the data will be grouped by birthing hospital and clinic site to calculate the referral rate based on the method of screening. Additionally, data will be compiled regarding whether patients were given an outpatient screening before referral for a diagnostic ABR. We believe that the hospitals will show a higher referral rate if the NBHS protocol utilizes only OAEs for both the initial and secondary in-patient screening or if the patient only had a single in-patient screening before being referred. Therefore, a greater number of patients will have typical hearing upon completion of the ABR. We infer that the birthing hospitals nearest to our rural remote clinic site will have an elevated rate of typical hearing thresholds following referral on their newborn hearing screening due to lack of access to the proper screening equipment, limited training, or unenforced protocols compared to the birthing hospitals located near the traditional site in the Houston, Texas metropolitan area.  This project will highlight the purpose of utilizing the newborn hearing screening protocols outlined in the JCIH 2019 Position Statement and the importance of appropriate training for newborn hearing screening technicians. Additionally, the inflated referral rate has further implications for the cost of clinic operations and staff resources. Finally, with the Texas LFU/LTD rate of 51.1% (CDC 2019), this concern poses a larger obstacle regarding how efficiently 1-3-6 protocols are being met in our state. This study was designed by the Director of Audiology at a pediatric facility and data is being collected and analyzed as a collaborative effort between the audiology extern and clinical audiologists. This study is currently in progress and will be completed before February 15, 2024.

Learning Objectives:

  • Upon completion, participants will be able to describe the effects of newborn hearing screening protocols on referral rates and their larger implications for local clinic resources and patient outcomes.