MCLEAN, Va.-- The American Academy of Audiology, the professional organization representing over 7,000 audiologist clinicians, educators and researchers, has raised several concerns related to the US Preventative Service Task Force (USPSTF) study of newborn hearing screening programs (www.ahrq.gov/clinic/3rduspstf/newhearrr.htm) and the corresponding article published today in the Journal of the American Medical Association. Although the press release and journal article raise important issues regarding identification and treatment of hearing loss in infants, some of the recommendations may be confusing or misinterpreted by consumers, if taken out of context.
The primary recommendation by the USPSTF is that there is a need for additional published research to determine the efficacy of universal newborn hearing screening of infants and newborns. The USPSTF is a panel of independent, private-sector experts in prevention and primary care medicine that reached its conclusion based on a report by the Evidence-based Practice Center at Oregon Health and Science University, which is supported by the Agency for Healthcare Research and Quality (AHRQ).
The USPSTF review examined two key questions: 1) the effectiveness and success of existing universal hearing screening programs, and 2) the evidence that children whose hearing loss is detected and treated earlier have better speech and language outcomes. The USPSTF reported good evidence that universal screening leads to earlier identification and treatment of infants with hearing loss. That said, according to USPSTF, examination of published literature to date is inconclusive whether this earlier identification and subsequent treatment leads to long-term improvements in speech and language skills.
The Chair of USPSTF, Alfred O. Berg, M.D., is quoted in today's press release as saying, 'Universal newborn hearing screening programs in more than 30 states provide an excellent opportunity to collect additional data that may help us determine the impact of screening on important clinical outcomes.' What is needed is additional prospective research and funding for hearing aids so that all infants identified with sensorineural hearing loss may be fit with hearing aids and/or cochlear implants with minimal delays.
Another issue raised by the USPSTF was the concern over high 'false positive' results from many newborn hearing screening programs with '...as many as 7 percent of infants diagnosed as having permanent PHL may eventually prove to have normal hearing.' This statement is misleading, in that infants are not 'diagnosed' with permanent hearing loss until the audiologist conducts a complete audiologic evaluation subsequent to the failure of the initial screening. Further, a review of the recent literature reveals much lower referral rates for programs that utilize audiologists and state-of-the-art test protocols (e.g. Vohr et al, Journal of Pediatrics. 139(2):238-44, 2001; Gorga et al, Journal of the American Academy of Audiology. 12(2):101-12, 2001). These studies and others suggest that all infants can be screened for hearing loss in a cost-effective manner.
American Academy of Audiology President David A. Fabry, Ph.D. said, 'Although we agree with USPSTF's statements regarding the need for further research, we also think it is important to build on the progress made to ensure that all babies born with hearing loss are fit with hearing aids as early as possible to minimize speech and language delays.'
The American Academy of Audiology continues to support the Joint Committee on Infant Hearing (JCIH) in its recommendations of newborn hearing screening and early intervention for hearing loss. The JCIH Year 2000 Position Statement may be found at: www.audiology.org/professional/positions/jcih-early.pdf
The American Academy of Audiology, the world's largest professional organization of audiologists, is dedicated to providing quality hearing care services through professional development, education, research and increased public awareness of hearing disorders. To learn more about the audiology profession and how audiologists are helping the 28 million Americans who suffer from hearing loss, please visit the Academy's web site at www.audiology.org
Concerns Over USPSTF Findings Related to Newborn Hearing Screening
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