The Effect Of First Screening Time On False Positive Rate Of Newborn Hearing Screening By Transiently Evoked Otoacoustic Emission

Objective:To investigate the appropriate time for first hearing screening after birth,and to reduce false positive rate(false positive rate,FPR)of first screening as much as possible.Methods:Selecting 7564 cases of normal birth neonates who were excluded the high risk factors of congenital hearing loss and born in the second hospital of Yueyang,Hunan province from August 2015 to December 2017.According to the different screening time of agreement,the subjects investigated were divided into 6 groups:A?B?C?D?E and F.The screening time was the second day after birth in group A,the third day in group B,and so on,the seven to nine days in group F.There were 1254 cases in group A,1336 cases in group B,1412 cases in group C,1438 cases in group D,1139 cases in E group,and 985 cases in F group.The first screening results in each group were compared with the results of reexamination in 1 months(27-30 days),42-60 days and 3 months after birth respectively.Results:After first hearing screening,the pass rates of A,B,C,D,E and F were 87.80%,90.27%,92.14%,93.88%,93.15% and 93.20%.After the second screening,the total pass rates were 94.02%,94.99%,95.04%,95%,94.29% and 94.62%.The total pass rate after third times of screening were 94.98%,95.28%,95.33%,95.33%,95.33% and 95.33%.The total pass rate after fourth times the by audiological diagnosis were 99.76%,99.93%,99.79%,99.72%,99.74% and 100%.After hearing screening,the false positive rates of A,B,C,D,E and F groups were 11.96%,9.56%,7.65%,5.84%,6.59% and 6.80%.The differences between each group two groups had no statistical significance after group C(P > 0.05).After the second screening,the false positive rates of A,B,C,D,E and F groups were 5.74%,4.94%,4.75%,4.73%,5.45% and 5.38%.After third times of screening,the false positive rates of A,B,C,D,E and F groups were 4.78%,4.65%,4.46%,4.45%,4.92% and 4.97%.The second screening and the third screening were compared with the first screening of the false positive rates,the differences had statistical significance of A?B and C groups(P<0.05),the differences had no statistical significance of E and F groups(P < 0.05).The differences between the second times and the third times of screening of the false positive rate of the 6 groups had no statistical significance(P>0.05).Conclusion: 1.The false positive rate of first hearing screening of neonates decreased with the delay of screening time;2.The differences of the false positive rate of hearing screening in fourth days after birth of neonates and 5-9 days was not significant;3.The neonates after birth were appropriately postponed the date of hearing screening during hospitalization,which was beneficial to reduce false positive rate.It is more suitable for hearing screening when the neonates in fourth days to fifth days after birth.4.It would be very meaningful to screen the neonates again who failed to pass the screening in the first 3 days around 1 month after birth.