Interdisciplinary approach to design, performance, and quality management in a multicenter newborn hearing screening project
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From the actual point of view, the “sensitive period” for the effects of hearing impairment on speech and language development is within the first year of life. Early exposure to acoustic or electric stimulation can compensate for the acoustic deficit. A regional-based, specifically designed concept of a universal newborn hearing screening (UNHS) was started in Hamburg in the year 2002. For the first time in Germany, a comprehensive protocol including screening measurement, follow-up procedures, tracking, and early intervention was implemented. An interdisciplinary approach from the very beginning could be realized. Sixty-three thousand, four hundred fifty-nine out of 65,466 births were registered during the period August 2002 to July 2006, 93% were primarily screened. 3.3% failed the test and 31.3% were lost to follow-up. A total of 118 children were diagnosed with hearing loss in the follow-up. The median age at time of diagnosis was 3.5 months. Seventy-four children received hearing aids. Out of these 74 children, 6 were subsequently supplied with cochlear implants. The high lost-to-follow-up rate is the biggest challenge for the tracking. Our results will be discussed in part II.
KeywordsInterdisciplinary approach Multicenter newborn hearing screening Screening and failure rate Lost-to-follow-up Number of babies with hearing losses
The project received partial funding from the Ministry for Social and Family Affairs (BSFM) and the Ministry of Environment and Health (BUG) in the first 2 years; the subsequent financing of the part-time jobs was supplied by funds donated to the H.A.H.N. e.V.. From August 2008 to January 2009, financing was supplied by the Social and Health Authority of Hamburg (BSG). None of the sponsors was involved in the study design, collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.
Training support was received from “Hamburg working group for hearing screening of newborns registered association” (Hamburger Arbeitskreis für Hörscreening bei Neugeborenen, eingetragener Verein (H.A.H.N. e.V.)). The authors are grateful to the staff and management of the participating hospitals, pediatricians, and pediatric audiologists without whom this project would have been unsuccessful. We thank each professional who identified the children for screening.
We thank Dr. Axel von der Wense, chairman of the H.A.H.N. e.V. for his valuable comments. We thank Professor Reinhard G. Matschke (Hannover, Germany) for his support and advice. We thank Mr. Hans-Joachim Wagner (service manager, Natus Europe) and Mr. Fritz Mack (general manager, Mack Medizintechnik GmbH) for their comments on the screening devices.
Conflict of interest
Neither the authors nor their departments have received any financial support from any industry or other external source related to the text in this manuscript.
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