Sensitivity and Specificity of Combined Physiological Tests in Newborn Hearing Screening

Abstract

Introduction: Newborn hearing screening has enabled the professionals to successfully detect a hearing loss at earliest. Successful hearing screening protocol involves a battery of tests, which should have high sensitivity and reduced false positive and negative responses. Moreover, protocol should be cost effective and less time consuming. Such protocol calls immediate implementation in screening program to detect hearing loss and certainly benefit beneficiaries to enroll in habilitation and or rehabilitation. Objective: To investigate sensitivity and specificity of individual and combined physiological hearing tests utilized in newborn hearing screening program. Method: A total of 572 ears (286 infants) were screened using high frequency tympanometry, acoustic reflex measure and transient evoked oto-acoustic emission (TEOAE). Despite all screening tests were passed auditory brainstem response (ABR) was measured at 30 dBnHL for confirmation of normal hearing. However, in ear where either acoustic reflex threshold for broadband noise or TEOAE was failed then detailed diagnostic ABR was carried out. Results: Sensitivity, specificity, false negative and false positive responses of individual test and combined physiological tests were determined. Results showed combined physiological measure revealed higher sensitivity (86%) and specificity (96%) and reduced false positive (0.3%) and false negative (1.3%) than each physiological measure. Conclusion: The protocol of combined physiological test in hearing screening accounts reduced false positive response there by decreases number of referrals. This in turn certainly reduces unnecessary parent tension regarding hearing status of their ward.