PMID- 9872244
OWN - NLM
STAT- MEDLINE
DCOM- 19990119
LR  - 20220317
IS  - 0140-6736 (Print)
IS  - 0140-6736 (Linking)
VI  - 352
IP  - 9145
DP  - 1998 Dec 19-26
TI  - Controlled trial of universal neonatal screening for early identification of 
      permanent childhood hearing impairment. Wessex Universal Neonatal Hearing 
      Screening Trial Group.
PG  - 1957-64
AB  - BACKGROUND: Congenital permanent childhood hearing impairment (PCHI) impairs 
      communication skills and, possibly, mental health and employment prospects. 
      Management within 1 year of birth can alleviate most of its adverse effects. 
      Neonatal screening for this disorder is feasible but its benefit for all babies 
      is disputed. We investigated whether neonatal screening of all babies born in 
      hospital, in addition to the standard health visitor distraction test, would 
      increase the rates of early referral, confirmation, and management. METHODS: 
      Between 1993 and 1996, two teams of four part-time testers and equipment moved 
      between two pairs of hospitals to achieve four periods with neonatal screening 
      and four without neonatal screening, each of 4-6 months' duration. Babies did or 
      did not undergo neonatal screening dependent on during which periods they were 
      born. We used a transient evoked otoacoustic emissions test and, in babies who 
      failed this test, an automated auditory brainstem response test on the same day. 
      We referred babies with positive results for audiological assessment. FINDINGS: 
      53,781 babies were included in the trial, and 25,609 were born during periods 
      with neonatal screening. Neonatal screening achieved 87% coverage of births, with 
      a false-alarm rate of 1.5%, and an overall yield of 90 cases of bilateral PCHI of 
      40 dB or more relative to hearing threshold level per 100,000 target population, 
      equivalent to 80% of the expected prevalence of the disorder in the population. 
      71 more babies with moderate or severe PCHI per 100,000 target population were 
      referred before age 6 months during periods with neonatal screening than during 
      periods without. Early confirmation and management of PCHI were significantly 
      increased. The rate of false-negative results from neonatal screening was 
      significantly lower than that for the distraction test (4 vs 27% p=0.041). 
      INTERPRETATION: Neonatal screening is effective in identification of congenital 
      PCHI early and may be particularly useful for babies with moderate and severe 
      PCHI for whom early management may have the most benefit.
LA  - eng
GR  - Wellcome Trust/United Kingdom
PT  - Clinical Trial
PT  - Comparative Study
PT  - Controlled Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Lancet
JT  - Lancet (London, England)
JID - 2985213R
SB  - IM
CIN - Lancet. 1998 Dec 19-26;352(9145):1951-2. PMID: 9872239
MH  - England/epidemiology
MH  - Evoked Potentials, Auditory, Brain Stem
MH  - Feasibility Studies
MH  - Hearing Loss, Bilateral/classification/congenital/*diagnosis/epidemiology
MH  - Humans
MH  - Infant, Newborn
MH  - Neonatal Screening/*methods
MH  - Risk Factors
MH  - Severity of Illness Index
EDAT- 1999/01/01 00:00
MHDA- 1999/01/01 00:01
CRDT- 1999/01/01 00:00
PHST- 1999/01/01 00:00 [pubmed]
PHST- 1999/01/01 00:01 [medline]
PHST- 1999/01/01 00:00 [entrez]
AID - S0140673698063594 [pii]
PST - ppublish
SO  - Lancet. 1998 Dec 19-26;352(9145):1957-64.