A two-stage bipodal screening model for universal neonatal hearing screening

Objective: A model is proposed for universal neonatal hearing screening. Methods: The screening model is two-staged because it consists of a first t est and, in case of failure (1.4% of the subjects), of a retest 3 weeks lat er. It is bipodal because it involves both the hospital audiologic departme nt and a central Well Baby Organization. The idea is to have a maximal numb er of newborns tested at the maternity by trained audiologists and to have the Well Baby Organization trace and chase the missing subjects. The model has been evaluated during 1 calendar year (1999) in a maternity with 2,012 newborns. Result: The result is a coverage of 99.3%. Most newborns (97.3%) were teste d at the maternity ward with a total time investment of less than 15 minute s per child. The actual test time is 2 minutes, 12 seconds (median value). The Well Baby Organization keeps track of all the results and has to test n o more than 2% of the newborns. Sensitivity and specificity were not the pr imary outcomes of this evaluation, but they were similar to those of a prev ious study evaluating the screen procedure on a larger scale, giving a sens itivity of approximately 100% and a false alarm rate of 1/1,000, Conclusion: These figures demonstrate that universal neonatal hearing scree ning is feasible within the existing health care structure, with unpreceden ted coverage, sensitivity, and specificity.