gms | German Medical Science

49. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds)
19. Jahrestagung der Schweizerischen Gesellschaft für Medizinische Informatik (SGMI)
Jahrestagung 2004 des Arbeitskreises Medizinische Informatik (ÖAKMI)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie
Schweizerische Gesellschaft für Medizinische Informatik (SGMI)

26. bis 30.09.2004, Innsbruck/Tirol

Universal Newborn Hearing Screening reduces the age at confirmation of hearing loss as compared to other screening strategies

Meeting Abstract (gmds2004)

  • corresponding author presenting/speaker Eva Grill - Department of Physical Medicine and Rehabilitation, University of Munich, München, Deutschland
  • Franz Hessel - Institute for Health Care Management, University of Duisburg-Essen, Essen, Deutschland
  • Uwe Siebert - Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School,, Boston, USA
  • Petra Schnell-Inderst - Institute for Social Pediatrics, University of Munich, München, Deutschland
  • Silke Kunze - Institute for Social Pediatrics, University of Munich, München, Deutschland
  • Andreas Nickisch - Institute for Social Pediatrics, University of Munich, München, Deutschland
  • Jürgen Wasem - Institute for Health Care Management, University of Duisburg-Essen, Essen, Deutschland

Kooperative Versorgung - Vernetzte Forschung - Ubiquitäre Information. 49. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 19. Jahrestagung der Schweizerischen Gesellschaft für Medizinische Informatik (SGMI) und Jahrestagung 2004 des Arbeitskreises Medizinische Informatik (ÖAKMI) der Österreichischen Computer Gesellschaft (OCG) und der Österreichischen Gesellschaft für Biomedizinische Technik (ÖGBMT). Innsbruck, 26.-30.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04gmds369

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gmds2004/04gmds369.shtml

Veröffentlicht: 14. September 2004

© 2004 Grill et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction

Approximately one to three per 1000 children are born with at least moderate, bilateral hearing disorders [1], [2]. The neurological development of hearing abilities requires acoustic stimulation in the first 18 months of life. Deficits due to lack of acoustic stimulation within the first two years are not or not easily recovered by later rehabilitation. The consequence is delayed development of speech as well as other cognitive and social functions. Children with connate hearing impairment benefit from early detection and treatment of their hearing loss [3]. There is no model that explicitly quantifies the effectiveness of universal newborn hearing screening (UNHS) versus other program alternatives in terms of early diagnosis, nor has it been taken into account that diagnosis of hearing impairment within the first few months of life is more "valuable" for further development than diagnosis later in life. Objective: To systematically compare two screening strategies for the early detection of new-born hearing disorders, UNHS and risk factor screening, with no systematic screening regarding their influence on early diagnosis.

Methods

Design: Clinical effectiveness analysis using a Markov Model [4]. Data Sources: Systematic literature review, empirical data survey, and expert opinion. Target Population: All newborn children. Time scale: 6, 12 and 120 months. Perspective: Health care system. Compared Strategies: UNHS, Risk factor screening (RS), no systematic screening (NS). Outcome Measures: Quality weighted detected child months (QCM).

Results

UNHS detected 644 QCM up until the age of 6 months (72,2%). RS detected 393 child months (44,1%) and no systematic screening 152 child months (17,0%). UNHS detected 74,3% and 86,7% weighted child months at 12 and 120 months, RS 48,4% and 73,3%, NS 23,7% and 60,6%. At the age of 6 months UNHS identified approximately 75% of all children born with hearing impairment, RS 50% and NS 25%. At the time of screening UNHS marked 10% of screened healthy children for further testing (false positives), RS 2%. UNHS demonstrated higher effectiveness even under a wide range of relevant parameters. The model was insensitive to test parameters within the assumed range but results varied along the prevalence of hearing impairment.

Conclusion

We have shown that UNHS is able to reduce the age at confirmation of hearing loss to a much greater extent as selective RS or NS. Further research should be performed on quality of life and health care utilization due to hearing loss and the proportion of children who follow a regular school and profession career after timely fitting of a hearing aid.


References

1.
Maki-Torkko EM, Lindholm PK, Vayrynen MRH, Leisti JT, Sorri MJ. Epidemiology of moderate to profound hearing impairments in northern Finland: any changes in ten years? Scand Audiol 1998(27):95-103.
2.
Fortnum H, Davis A. Epidemiology of permanent childhood hearing impairment in Trent Region. 1985-1993. Br J Audiol 1997;31:409-46.
3.
Yoshinaga-Itano C, Sedey AL, Coulter DK, Mehl AL. Language of early- and later-identified children with hearing loss. Pediatrics 1998;102:1161-71..
4.
Sonnenberg FA, Beck JR. Markov models in medical decision making: a practical guide. Med Decis Making 1993;13:322-38