missouri newborn hearing screening program: a report on the first two years
DESCRIPTION
Missouri Newborn Hearing Screening Program: A Report on the First Two Years. Missouri Department of Health and Senior Services. Initial Hearing Screenings Used in Missouri Hospitals. Automated Auditory Brainstem Response(ABR) Otoacoustic Emissions (OAE). 36%. 45%. 19%. - PowerPoint PPT PresentationTRANSCRIPT
Missouri Newborn Hearing Missouri Newborn Hearing Screening Program: A Report Screening Program: A Report
on the First Two Yearson the First Two Years
Missouri Newborn Hearing Missouri Newborn Hearing Screening Program: A Report Screening Program: A Report
on the First Two Yearson the First Two Years
Missouri Department of Health and Missouri Department of Health and Senior ServicesSenior Services
Initial Hearing Initial Hearing Screenings Used in Screenings Used in Missouri HospitalsMissouri Hospitals
• Automated Auditory Brainstem Response(ABR)
• Otoacoustic Emissions (OAE)
OAE
A-ABR
Combination
19%
36% 45%
Statistics on Initial ScreeningStatistics on Initial ScreeningStatistics on Initial ScreeningStatistics on Initial Screening
Screening data for years 2002-2003150,476 newborns screened (97.6%
live births in state)5,613 referred to audiologists (3.7%)
Decline in ReferralsDecline in ReferralsDecline in ReferralsDecline in Referrals
0
1
2
3
4
5
2002 2003
PercentReferred
FromInitial
Screening
Re-ScreeningRe-ScreeningRe-ScreeningRe-Screening
• Summary level data is incomplete
• Difficulties getting hospitals/clinics to send re-screening information
•Technical issues with data entry on re-screening portion of hearing system
What happens to NewbornsWhat happens to NewbornsWho Fail their Initial Screen?Who Fail their Initial Screen?
20%
Seen byAudiologist
41%Pass subsequentScreening Test
39%
UnknownOutcome
Audiologist Exam ResultsAudiologist Exam ResultsNewborn Hearing Screening Program collected 1,213 audiologist reports from 2002 & 2003
67.8%Were seen by
AudiologistWithin
3 months of birth
32.2%Were not
seenwithin
3 months of birth
Audiologist Exam ResultsAudiologist Exam ResultsNewborn Hearing Screening Program collected 1,213 audiologist reports from 2002 & 2003
25%(299 Cases)
Diagnosis ofConfirmed Hearing
Loss 75%(914 Cases)
No Confirmed Hearing Loss
Confirmed Cases of Hearing LossConfirmed Cases of Hearing Loss
• 299 Confirmed Cases• Matched 287/299 records to Birth Certificate• 13 Cases infant passed initial screening but audiologist later confirmed hearing loss diagnosis• 43 Records removed—further testing revealed infants hearing were within normal ranges• Final data set contained 244 records
Confirmed Cases of Hearing LossConfirmed Cases of Hearing Lossby Date of Birthby Date of Birth
0
20
40
60
80
100
120
140
2002 2003
Number ofConfirmed
Cases
Hearing Loss byHearing Loss byGender and RaceGender and Race
0
0.5
1
1.5
2
2.5
3
Male
Female
White
Black
Other
HearingLossRatePer
1,000 Live
Births
Gender Race
Missouri State Average = 1.58
Hearing LossHearing Lossby Maternal Ageby Maternal Age
0
0.5
1
1.5
2
2.5
U18 18-19 20-24 25-29 30-34 35-39 40 &Over
Mother’s Age
Missouri State Average = 1.58
Hearing LossHearing Lossby Maternal Ageby Maternal Age
0
1
2
3
4
5
6
7
U20 20-24 25-29 30-34 35-39 40 &Over
HearingLossRatePer
1,000 Live
Births
Mother’s Age
Low Birth Weight All Births Regular Weight Only
Hearing Loss Hearing Loss by Birth Weightby Birth Weight
0123456789
10
VLB MLB > 2,500*1,500 –2,500*
< 1,500** grams
HearingLossRatePer
1,000 Live
Births
Hearing Loss byHearing Loss byAPGAR ScoreAPGAR Score
0
1
2
3
4
5
6
7
8
Normal < 5 < 7
After 1 Min. After 5 Min.
HearingLossRatePer
1,000 Live
Births
Hearing Loss &Hearing Loss &Cleft Lip/PalateCleft Lip/Palate
0
10
20
30
40
50
Non CL/P Cleft Lip/Palate
(7 Cases)
HearingLossRatePer
1,000 Live
Births
Hearing Loss by Type and DegreeHearing Loss by Type and Degree
SensorineuralConductiveMixedUnknown
120Cases
62
60
2
Type of Loss Degree of Hearing Loss forSensorineural Type Loss
MildModerateSevereProfound
Unknown
44
31
14
27
4
Severe and Profound Hearing LossSevere and Profound Hearing Loss
Type of Loss forSevere and Profound Hearing Loss
SensorineuralConductiveMixedUnknown
41Cases5
28
Unilateral/Bilateral Hearing LossUnilateral/Bilateral Hearing Loss
Unilateral/BilateralHearing Loss
BilateralUnilateralUnknown
124Cases
102
18
Unilateral/Bilateral for Severe or Profound Hearing Loss
BilateralUnilateralUnknown
3520
1
Days from Birth to DiagnosisDays from Birth to Diagnosis
0
20
40
60
80
100
120
140
Mild Moderate Severe Profound Unknown
Degree of Loss
Avg#Of
Days
3 Month Goal of NewbornHearing Program
=
Percent of Births MeetingPercent of Births MeetingThree Month GoalThree Month Goal
010
203040
50607080
90100
Mild Moderate Severe Profound Unknown
Degree of Loss
Overall 71.4% of Missouri newborns with hearing loss diagnosed by three month goal