Support of universal newborn hearing screening among mothers and health care providers

Authors


Terry C Wall, MD, MPH, Division of General Pediatrics, 1616 6th Avenue South, Suite 201, Birmingham, AL 35233, USA, Tel: (205) 939 9585; Fax: (205) 975 6503; e-mail: twall@peds.uab.edu

ABSTRACT

Background Despite the 1994 Joint Committee on Infant Hearing recommendation that all newborns receive hearing screens, many in the United States are not screened by 3 months of age.

Objectives To assess mothers’, pediatricians’, and hearing specialists’ preferences for targeted versus universal newborn hearing screening.

Study design An interactive computer-based interview, applying the analytical hierarchical process, was used to quantify preference scores for 95 post-partum women selected randomly from an obstetric ward at a university hospital and for 40 primary care pediatricians and 40 hearing specialists (audiologists and otolaryngologists) randomly selected from a local community. The main outcome of interest was preference for targeted versus universal newborn hearing screening. Three objectives were compared minimize missed hearing loss, minimize unnecessary tests, and minimize cost. Unnecessary tests included consideration of test time, test accuracy, and need for follow-up hearing evaluations.

Results The majority of respondents in all three groups (97.5% hearing specialists, 82.5% pediatricians, and 89.5% mothers) favored universal over targeted screening. Differences in mean preference scores were statistically significant between hearing specialists and pediatricians (p < 0.005) and between hearing specialists and mothers (p < 0.005). All three groups ranked risk of missed hearing impairment as the most important consideration. Hearing specialists placed more weight on importance of not missing a case of hearing loss and less on unnecessary tests than mothers and pediatricians.

Conclusions Even though universal newborn hearing screening was preferred by the three groups examined, a small but significant minority of pediatricians and mothers preferred targeted screening.

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