Comparison of the CAPAS and Ewing tests for screening of hearing in infants

Objective-To study the similarities and differences between the non-automat ed labour intensive Ewing hearing test and the less labour intensive automa ted CAPAS (Compact Amsterdam Paedo-Audiometrical Screening) hearing test. S etting-A multicentre study in which all the children born in the eastern pa rt of the Netherlands between 1 January 1996 and I April 1997 were routinel y screened for hearing impairment at 9 months of age. Methods-Differences and similarities between the two methods were described for the proportion of children who failed every test, the percentage of re ferred children, the yield of bilateral and unilateral otitis media with ef fusion (OME), the positive predictive value of the third test result, and t he yield of persistent OME after 4-6 months' follow up at an ENT department . Results-12 603 infants were screened with the CAPAS test and 17 496 with th e Ewing test. There were differences between the CAPAS and Ewing tests resp ectively in the proportions of children lost to follow up (10.1% v 15.2%), the proportions of children referred diagnosed with OME (59% v 81%), the yi eld of bilateral otitis media with effusion (2.4% rt 3.0%), and the yield o f persistent OME after 4-6 months' follow up (1.1% v 1.6%). Conclusions-The CAPAS test is more practical than the Ewing test, but the n onautomated Ewing test seems to be more reliable and valid for detecting co nductive hearing loss.