Auditory and Vestibular Research 2015. 24(3):141-151.

The sensitivity and specificity of automated auditory brainstem response and otoacoustic emission in neonatal hearing screening: a systematic review
Saeed Heidari, Alireza Olyaee Manesh, Fatemeh Rajabi


Background and Aim: Otoacoustic emissions (OAE) and automated auditory brainstem response (AABR) are the most commonly-used methods for universal neonatal hearing screening (UNHS). Various sensitivity and specificity rates have been reported for the OAE and AABR tests as tools for screening newborn hearing. The main objective of this review was to determine the pooled sensitivity and pooled specificity of each of the two devices in comparison with ABR as the gold standard.
Methods: A systematic review was performed to evaluate the diagnostic accuracy of the OAE and AABR tests. Research was conducted in the relevant domestic and international databases. There were no time restrictions. The quality of included studies was evaluated with Quality Assessment of Diagnostic Accuracy Study (QUADAS) checklist using the software RevMan 5.1 and results were extracted. After organizing and extracting data, the pooled sensitivity and specificity of OAE and AABR tests were calculated with Meta-Disc software.
Results: A total of 5154 articles were found; 57 articles were investigated in full and 17 articles possessed the inclusion criteria. Analysis was performed on the basis of these results. the quality of the studies was weak (7 cases) to moderate (10 cases). Results of the meta-analysis showed that the pooled sensitivity and specificity of the OAE were 0.77 and 0.93 respectively, and for AABR they were 0.93 and 0.97 respectively.
Conclusion: The single stage screening protocol using AABR is an effective alternative to the single stage screening protocol using OAE, which is less accurate.


Newborn hearing screening; otoacoustic emissions; automated auditory brainstem response; sensitivity; specificity

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