The sensitivity and specificity of automated auditory brainstem response and otoacoustic emission in neonatal hearing screening: a systematic review
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.
2. World Health Organization. Newborn and infant hearing screening: Current issues and guiding principles for action. 2010;  available from: www.who.int/blindness/publications/Newborn and Infant Hearing Screening Report.pdf. Mar:15.2015.
3. Akinpelu OV, Peleva E, Funnell WR, Daniel SJ. Otoacoustic emissions in newborn hearing screening: a systematic review of the effects of different protocols on test outcomes. Int J Pediatr Otorhinolaryngol. 2014;78(5):711-7.
4. Firouzbakht M, Eftekhar Ardebili H, Majlesi F, Rahimi A, Ansari Dezfooli M, Esmailzadeh M. Prevalence of neonatal hearing impairment in province capitals. Journal of the School of Public Health and Institute of Public Health Research. 2008;5(4):1-9. Persian.
5. Callow-Heusser CA. The effects of early identification and intervention on language outcomes of children born with hearing loss. [Dissertation]. Utah State University. 2011.
6. Corabian P, Harstall C, Yan C, Chuck A, Chojecki D. The safety and efficacy/effectiveness of using automated testing devices for universal newborn hearing screening: an update. IHE2012.;  available from: www.ihe.ca/publications?date=2012&topic=1043. Mar:15.2015
7. The Cochrane Collaboration. Review Manager (RevMan). Version 5.0. 2008. Copenhagen: The Nordic Cochrane Centre.
8. Jacobson JT, Jacobson CA. The effects of noise in transient EOAE newborn hearing screening. Int J Pediatr Otorhinolaryngol. 1994;29(3):235-48.
9. Reuter G, Bördgen F, Dressler F, Schäfer S, Hemmanouil I, Schönweiler R, et al. Neonatal hearing screening with the Echosensor automated device for otoacoustic emissions. A comparative study. HNO. 1998;46(11):932-41. German.
10. Stevens JC, Webb HD, Hutchinson J, Connell J, Smith MF, Buffin JT. Click evoked otoacoustic emissions compared with brain stem electric response. Arch Dis Child. 1989;64(8):1105-11.
11. Apostolopoulos NK, Psarommatis IM, Tsakanikos MD, Dellagrammatikas HD, Douniadakis DE. Otoacoustic emission-based hearing screening of a Greek NICU population. Int J Pediatr Otorhinolaryngol. 1999;47(1):41-8.
12. Smyth V, McPherson B, Kei J, Young J, Tudehope D, Maurer M, et al. Otoacoustic emission criteria for neonatal hearing screening. Int J Pediatr Otorhinolaryngol. 1999;48(1):9-15.
13. Liao H, Wu Z, Zhou T. Otoacoustic emissions for newborn hearing screening. Zhonghua Er Bi Yan Hou Ke Za Zhi. 1999;34(1):21-4. Chinese.
14. Luppari R, Orzan E, Arslan E. Acoustic distortion products otoacoustic emissions (DPOAE) in neonatal screening. Acta Otorhinolaryngol Ital. 1999;19(2):57-63. Italian.
15. Dhawan R, Mathur NN. Comparative evaluation of transient evoked oto-acoustic emissions and brainstem evoked response audiometry as screening modality for hearing impairment in neonates. Indian J Otolaryngol Head Neck Surg. 2007;59(1):15-8.
16. Boo NY, Rohani AJ, Asma A. Detection of sensorineural hearing loss using automated auditory brainstem-evoked response and transient-evoked otoacoustic emission in term neonates with severe hyperbilirubinaemia. Singapore Med J. 2008;49(3):209-14.
17. Yousefi J, Ajalloueyan M, Amirsalari S, Hassanali Fard M. The specificity and sensitivity of transient otoacustic emission in neonatal hearing screening compared with diagnostic test of auditory brainstem response in Tehran hospitals. Iran J Pediatr. 2013;23(2):199-204.
18. Kuki S, Chadha S, Dhingra S, Gulati A. The role of current audiological tests in the early diagnosis of hearing impairment in infant. Indian J Otolaryngol Head Neck Surg. 2013;65(3):244-50.
19. Hall J, Kileny P, Ruth R, Kripal JP. Newborn auditory screening with ALGO-1 vs. conventional ABR. ASHA. 1987;29:120.
20. Schauseil-Zipf U, von Wedel H. Hearing screening using acoustically evoked brainstem potentials in newborn infants and infants. Klin Padiatr. 1988;200(4):324-9. German.
21. Jacobson JT, Jacobson CA, Spahr RC. Automated and conventional ABR screening techniques in high-risk infants. J Am Acad Audiol. 1990;1(4):187-95.
22. Herrmann BS, Thornton AR, Joseph JM. Automated infant hearing screening using the abr: development and validation. Am J Audiol. 1995;4(2):6-14.
23. Melagrana A, Casale S, Calevo MG, Tarantino V. MB11 BERAphone and auditory brainstem response in newborns at audiologic risk: comparison of results. Int J Pediatr Otorhinolaryngol. 2007;71(8):1175-80.
24. Sena-Yoshinaga TA, Almeida MG, Côrtes-Andrade IF, Lewis DR. Neonatal hearing screening with automated auditory brainstem response: using different technologies. Audiol Commun Res. 2014;19(1):19-24.
25. Wolff R, Hommerich J, Riemsma R, Antes G, Lange S, Kleijnen J. Hearing screening in newborns: systematic review of accuracy, effectiveness, and effects of interventions after screening. Arch Dis Child. 2010;95(2):130-5.
26. White KR. Universal newborn hearing screening: Issues and evidence. Atlanta, GA: Workshop on Early Hearing Detection and Intervention (EHDI). 1997;  available from: www.infanthearing.org/summary/materials/cdc.pdf. Mar:15.2015.
Copyright (c) 2015 Auditory and Vestibular Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.