Measures of follow-up in early hearing detection and intervention programs: a need for standardization

Am J Audiol. 2008 Jun;17(1):60-7. doi: 10.1044/1059-0889(2008/007).

Abstract

Purpose: To demonstrate the need for standardized data definitions and reporting for early hearing detection and intervention (EHDI) programs collecting information on newborn hearing screening and follow-up, and types of information best collected in a standardized manner.

Method: A hypothetical birth cohort was used to show the potential effects of nonstandardized definitions and data classifications on rates of hearing screening, audiologic follow-up, and hearing loss.

Results: The true screening rate in this cohort was 92.4%. The calculated rate was between 90.0% and 96.5%, depending on the measure used. Among children documented as screened and referred for follow-up, 61.0% received this testing. Only 49.0% were documented to have been tested. Despite a true prevalence of 3.7 per 1,000 births, only 1.5 per 1,000 children were documented with a hearing loss.

Conclusion: Ensuring that children receive recommended follow-up is challenging. Without complete reporting by audiologists to EHDI programs, accurate calculation of performance measures is impossible. Lack of documentation can lead to the overstatement of "loss to follow-up." Also, standardization of measures is essential for programs to evaluate how many children receive recommended services and assess progress toward national goals. A new survey has been implemented to collect more detailed and standardized information about recommended services.

MeSH terms

  • Audiology / instrumentation
  • Child, Preschool
  • Documentation / methods
  • Early Diagnosis*
  • Follow-Up Studies
  • Health Services Needs and Demand*
  • Hearing Disorders* / diagnosis
  • Hearing Disorders* / epidemiology
  • Hearing Disorders* / therapy
  • Humans
  • Mass Screening / methods*
  • Mass Screening / standards*
  • Prevalence
  • Program Development*