Newborn Hearing Screening: Summary of Evidence. Table 5. Strength of Evidence for Universal Newborn Hearing Screening--Redirect

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Table 5. Strength of Evidence for Universal Newborn Hearing Screening^a

Key Question	Evidence Code^b	Quality of Evidence
1a. Can UNHS accurately diagnose moderate-to-profound sensorineural hearing impairment? OAE and ABR are highly accurate screening tests for congenital PHL (sensitivity 84%, specificity 90%).	II-1, II-2	Good: One controlled trial measured the predictive value of a positive test result (6.7%), and a good quality cohort study measured sensitivity and specificity against an independent gold standard.
1b. In UNHS programs, how many children are identified and treated before 6 months? UNHS increases the chance that diagnosis and treatment will occur before 6 months of age. UNHS increases early identification between 19% and 42% over selective screening in high-risk children.	II-1, II-2	Good: One controlled study in the United Kingdom and 1 cohort study in the United States reported the frequency of treatment before 10 and 6 months, respectively. Other studies did not provide sufficient information, and none included patients who, although screened, were diagnosed and treated late because of loss to followup. However, no controlled trials of UNHS versus selective screening have been done.
2. Does identification and treatment prior to 6 months improve language and communication in infants who would not be diagnosed that early in a selective, high-risk screening program? Evidence is inconclusive.	II-2, II-3	Fair/Poor: Studies have selection bias and baseline differences between compared groups. These studies did not specifically describe outcomes in the subgroup of children who would be identified by UNHS but not by selective screening.
3. What are the potential adverse effects of screening and early treatment? Evidence is inconclusive.	III	Poor: Most postulated adverse effects have not been evaluated in studies.

^a ABR indicates automated brainstem response; OAE, otoacoustic emissions; PHL, permanent hearing loss; UNHS, universal newborn hearing screening.
^bEvidence codes: I: Randomized controlled trial; II-1: Controlled trial without randomization; II-2: Cohort or case-control analytic study; II-3: Multiple time series, dramatic uncontrolled experiments; III: Opinions of respected authorities.

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Table 5. Strength of Evidence for Universal Newborn Hearing Screeninga

Table 5. Strength of Evidence for Universal Newborn Hearing Screening^a