scholarly journals Contralateral Ear Occlusion for Improving the Reliability of Otoacoustic Emission Screening Tests

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Emily Papsin ◽  
Adrienne L. Harrison ◽  
Mattia Carraro ◽  
Robert V. Harrison
Keyword(s):  
Ambient Noise ◽  
Otoacoustic Emission ◽  
Acoustic Stimulation ◽  
Hearing Screening ◽  
Screening Tests ◽  
Newborn Hearing Screening ◽  
Noise Levels ◽  
Distortion Product ◽  
Newborn Hearing ◽  
Contralateral Ear

Newborn hearing screening is an established healthcare standard in many countries and testing is feasible using otoacoustic emission (OAE) recording. It is well documented that OAEs can be suppressed by acoustic stimulation of the ear contralateral to the test ear. In clinical otoacoustic emission testing carried out in a sound attenuating booth, ambient noise levels are low such that the efferent system is not activated. However in newborn hearing screening, OAEs are often recorded in hospital or clinic environments, where ambient noise levels can be 60–70 dB SPL. Thus, results in the test ear can be influenced by ambient noise stimulating the opposite ear. Surprisingly, in hearing screening protocols there are no recommendations for avoiding contralateral suppression, that is, protecting the opposite ear from noise by blocking the ear canal. In the present study we have compared transient evoked and distortion product OAEs measured with and without contralateral ear plugging, in environmental settings with ambient noise levels <25 dB SPL, 45 dB SPL, and 55 dB SPL. We found out that without contralateral ear occlusion, ambient noise levels above 55 dB SPL can significantly attenuate OAE signals. We strongly suggest contralateral ear occlusion in OAE based hearing screening in noisy environments.

scholarly journals Feasibility of newborn hearing screening in a public hospital setting in South Africa: A pilot study

2016 ◽  
Vol 63 (1) ◽  
Author(s):  
Amisha Kanji ◽  
Katijah Khoza-Shangase
Keyword(s):  
South Africa ◽  
Pilot Study ◽  
Otoacoustic Emissions ◽  
Ambient Noise ◽  
Hospital Setting ◽  
Hearing Screening ◽  
Newborn Hearing Screening ◽  
Noise Levels ◽  
Newborn Hearing ◽  
Brainstem Response

Objectives: The current pilot study aimed to explore the feasibility of newborn hearing screening (NHS) in a hospital setting with clinical significance for the implementation of NHS. Context-specific objectives included determining the average time required to screen each neonate or infant; the most suitable time for initial hearing screening in the wards; as well as the ambient noise levels in the wards and at the neonatal follow-up clinic where screening would be conducted.Method: A descriptive, longitudinal, repeated measures, within-subjects design was employed. The pilot study comprised 11 participants who underwent hearing screening. Data were analysed using descriptive statistics.Results: The average time taken to conduct hearing screening using otoacoustic emissions and automated auditory brainstem response was 18.4 minutes, with transient evoked otoacoustic emissions taking the least time. Ambient noise levels differed between wards and clinics with the sound level readings ranging between 50 dBA and 70 dBA. The most suitable screening time was found to be the afternoons, after feeding times. Conclusion: Findings highlight important considerations when embarking on larger scale NHS studies or when planning a hospital NHS programme. Current findings suggest that NHS can be efficiently and effectively conducted in public sector hospitals in South Africa, provided that test time is considered in addition to sensitivity and specificity when deciding on a screening protocol; bar recognised personnel challenges.

The Impact of Pass/Refer Criteria in the Use of Otoacoustic Emission Technology for Newborn Hearing Screening

2021 ◽  
pp. 1-7
Author(s):  
Amisha Kanji ◽  
Alida Naudé
Keyword(s):  
Repeated Measures ◽  
Otoacoustic Emissions ◽  
Screening Program ◽  
Otoacoustic Emission ◽  
Hearing Screening ◽  
Newborn Hearing Screening ◽  
Distortion Product ◽  
Repeated Measures Design ◽  
Newborn Hearing ◽  
The Impact

Purpose The current study aimed to compare the specificity of transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) in isolation and in combination, with varying pass/refer criteria for DPOAE technology. Method A longitudinal, repeated-measures design was employed. The current study sample comprised 91 of the initial 325 participants who returned for the repeat screening and diagnostic audiological assessment within a risk-based newborn hearing screening program. Results TEOAE screening had the highest specificity in comparison to DPOAE screening at the initial and repeat screening, irrespective of differences in DPOAE pass/refer criteria. DPOAE screening had a slightly higher specificity, with a three out of six rather than the four out of six frequency pass criteria. Conclusions Pass/refer criteria alone do not influence referral rates and specificity. Instead, consideration of other factors in combination with these criteria is important. More research is required in terms of the sensitivity and specificity of OAE screening technology using repeated-measures and diagnostic audiological evaluation as the gold standard.

Outcome of Newborn Hearing Screening by ABR Compared With Four Different DPOAE Pass Criteria

2000 ◽  
Vol 9 (2) ◽  
pp. 142-148 ◽  
Author(s):  
Susan E. Barker ◽  
Marci M. Lesperance ◽  
Paul R. Kileny
Keyword(s):  
Otoacoustic Emission ◽  
Hearing Screening ◽  
Risk Indicators ◽  
Newborn Hearing Screening ◽  
Distortion Product Otoacoustic Emission ◽  
Auditory Brain Stem Response ◽  
Screening Programs ◽  
Distortion Product ◽  
Auditory Brain Stem ◽  
Newborn Hearing

The purpose of this study is to compare the effectiveness and utility of distortion product otoacoustic emission (DPOAE) and auditory brain stem response (ABR) testing as screening methodologies suitable for universal application at a large birthing hospital. Five hundred sixty-nine neonates (1184 ears) without risk indicators for hearing loss underwent DPOAE and ABR screening before hospital discharge at birth. All ears (100%) passed the ABR screening. DPOAE results were categorized on the basis of the number of frequencies at which emissions were obtained as well as presence versus absence of a replicated response at each test frequency. Pass and refer rates varied widely, on the basis of whether the presence of DPOAE response at 2000 Hz or replication were required. With the most stringent criteria, only 64.44% of ears passed, whereas with the least stringent criteria 88.94% passed. Given that 100% of ears passed according to the gold standard of the ABR screening, these results indicate false-positive rates ranging from 11% to 35% by DPOAE screening. This discrepancy in pass and refer rates when various criteria are applied indicates the need for standardization and further comparison of appropriate pass criteria for newborn hearing screening programs.

Objective Hearing Screening Measures: An Exploration of a Suitable Combination for Risk-Based Newborn Hearing Screening

2018 ◽  
Vol 29 (06) ◽  
pp. 495-502 ◽  
Author(s):  
Amisha Kanji ◽  
Katijah Khoza-Shangase
Keyword(s):  
Otoacoustic Emissions ◽  
Hearing Screening ◽  
Newborn Hearing Screening ◽  
Paired Data ◽  
Distortion Product ◽  
Repeated Measures Design ◽  
Automated Auditory Brainstem Response ◽  
Newborn Hearing ◽  
Brainstem Response ◽  
Screening Measures

AbstractThe ideal hearing screening measure is yet to be defined, with various newborn hearing screening protocols currently being recommended for different contexts. Such diverse recommendations call for further exploration and definition of feasible and context-specific protocols.The aim of the study was to establish which combinations of audiological screening measures provide both true-positive (TP) and true-negative (TN) results for risk-based hearing screening, at and across time.A longitudinal, repeated-measures design was employed.Three-hundred and twenty-five participants comprised the initial study sample. These participants comprised newborns and infants who were discharged from the neonatal intensive care unit and high care wards to “step down” wards at two public sector hospitals within an academic hospital complex.Transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), and automated auditory brainstem response (AABR) were conducted at the initial and repeat hearing screening. Diagnostic audiological assessments were also conducted. Results from combinations of audiological screening measures at the initial and repeat hearing screening were analyzed in relation to the final diagnostic outcome (n = 91). Participants were classified as presenting with an overall “refer” if the outcome for any one test was “refer.” The overall screening outcomes for different test combinations were compared using McNemar’s test for paired data. Proportions across different test combinations were compared by the z-test for proportions.Because of the absence of participants with hearing loss in the current study sample, analysis could only be conducted in relation to TN findings (specificity) and not TP findings (sensitivity). The percentage of TN findings was highest at the repeat hearing screening using any test or combination of tests when compared with findings from the initial hearing screening. TEOAE combined with AABR (TEOAE/AABR) (p < 0.0001), DPOAE combined with AABR (DPOAE/AABR) (p < 0.0001), and the combination of all three screening measures (p < 0.0001) yielded the highest percentage specificity at the repeat hearing screening when compared with the initial hearing screening.The best specificity was noted at the repeat hearing screening. Within a resource stricken context, where availability of all screening measures options may not be feasible, current study findings suggest the use of a two-stage AABR protocol or TEOAE/AABR protocol.

scholarly journals Hearing Screening in the Community

2019 ◽  
Vol 30 (02) ◽  
pp. 145-152 ◽  
Author(s):  
Gabrielle H. Saunders ◽  
Melissa T. Frederick ◽  
ShienPei C. Silverman ◽  
Tina Penman ◽  
Austin Gardner ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Failure Rate ◽  
Pure Tone ◽  
Ambient Noise ◽  
Failure Criteria ◽  
Hearing Screening ◽  
Self Report ◽  
Screening Tests ◽  
Noise Levels ◽  
Sound Levels

AbstractAdults typically wait 7–10 yr after noticing hearing problems before seeking help, possibly because they are unaware of the extent of their impairment. Hearing screenings, frequently conducted at health fairs, community events, and retirement centers can increase this awareness. To our knowledge, there are no published studies in which testing conditions and outcomes have been examined for multiple “typical screening events.”The purpose of this article is to report hearing screening outcomes for pure tones and self-report screening tests and to examine their relationship with ambient noise levels in various screening environments.One thousand nine hundred fifty-four individuals who completed a hearing screening at one of 191 community-based screening events that took place in the Portland, OR, and Tampa, FL, metro areas.The data were collected during the recruitment phase of a large multisite study. All participants received a hearing screening that consisted of otoscopy, pure-tone screening, and completion of the Hearing Handicap Inventory–Screening Version (HHI-S). In addition, ambient sound pressure levels were measured just before pure-tone testing.Many more individuals failed the pure-tone screening (n = 1,238) and then failed the HHI-S (n = 796). The percentage of individuals who failed the pure-tone screening increased linearly with age from <20% for ages <45 yr to almost 100% for individuals aged ≥85 yr. On the other hand, the percentage of individuals who failed the HHI-S remained unchanged at approximately 40% for individuals aged ≥55 yr. Ambient noise levels varied considerably across the hearing screening locations. They impacted the pure-tone screen failure rate but not the HHI-S failure rate.It is important to select screening locations with a quiet space for pure-tone screening, use headphones with good passive attenuation, measure sound levels regularly during hearing screening events, halt testing if ambient noise levels are high, and/or alert individuals to the possibility of a false-positive screening failure. The data substantiate prior findings that the relationship between pure-tone sensitivity and reported hearing loss changes with age. Although it might be possible to develop age-specific HHI-S failure criteria to adjust for this, such an endeavor is not recommended because perceived difficulties are the best predictor of hearing health behaviors. Instead, it is proposed that a public health focus on education about hearing and hearing loss would be more effective.

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