The Specificity and Sensitivity of Transient Otoacustic Emission in Neonatal Hearing Screening Compared with Diagnostic Test of Auditory Brain Stem Response in Tehran Hospitals|
Yousefi, Jaleh; Ajalloueyan, Mohammad; Amirsalari, Susan & Fard, Mahdieh Hassanali
Objective: Since early detection (specially before 6 months of age) of deaf people leads to better hearing and
speech outcome after treatment, several clinical trials have been performed in order to find a cost effective,
short duration screening test for diagnosis of neonatal hearing impairment. The aim of this study was to
assess the sensitivity and specificity of Transient Otoacustic Emission (TEOAE) test in newborns comparing
with auditory brain stem response (ABR) in the age of 3 months and to analyze the association between risk
factors and hearing loss in neonates.
Methods: A cross-sectional study was conducted January2008 - May 2009 in Tehran. 1000 newborns (526
boys and 474 girls) were assessed. First, all of neonates were evaluated by TEOAE 24h after birth. If responses
of OAE were failing, they were retested 10 to 15 days after birth by TEOAE. Also, All Neonates were assessed
by ABR in the age of 3 months. Descriptive Statistics was used to analyze data.
Findings: Eighteen out of 1000 neonates failed double–checked TEOAE tests, of which 6 were confirmed by
ABR test (12 false positive results). Nine out of 1000 neonates had impaired ABR tests, from these patients, 6
had failed OAE as well, but 3 had normal OAE (3 false negative results). From these 9 patients 2 had profound
hearing loss and received cochlear implantation. We found that OAE has 66.7% sensitivity and 98.8%
specificity in diagnosis of neonatal hearing impairment. Its positive and negative predictive value was 33.3%
and 99.7% respectively. Also we did not find statistically significant relationship between hearing loss and
Conclusion: TEOAE as a simple, non-invasive, short duration and cost effective method, is a suitable test for
neonatal hearing screening. Even though only two thirds of patients were detected by this method, 99.7%
negative predictive value makes it a good screening test. We recommend OAE as a suitable primary neonatal
hearing screening all over the country.
Hearing Loss; Sensitivity; Specificity; Auditory Brain Stem Response; Otoacustic Emission