Hearing Screening Research Articles

COVID Effects on Adherence to Joint Committee on Infant Hearing Newborn Screening Recommendations.

Despite significant improvements in universal newborn hearing screenings (NBHS), infants are still lost to follow-up (LTF) after failed screening, delaying timely diagnosis and intervention. The challenges during the COVID-19 pandemic and its response likely exacerbated timely adherence to early diagnosis and intervention. This study aimed to assess the LTF rate for infants who did not pass their NBHS within Washington, DC and compare the LFT before and during the pandemic. Cohort study analyzing variables potentially impacting LTF. Web-based analysis of DC Oz e-Screener Plus for NBHS reports. Multivariate and univariate regression analyses were used to identify significant demographic and clinical factors from March 2019 to March 2021. Of the 15,661 born during the period analyzed, 830 (5.3%) infants did not pass their initial hearing screening: 406 (48.9%) infants in the pre-COVID group and 424 (51.1%) infants in the COVID group. Of those infants failing their initial screening, 388 (46.7%) did not pass a follow-up outpatient screening. Of these, 342 (88.1%) had no record of receiving a Diagnostic Auditory Brainstem Response assessment. The overall LTF rate in the pre-COVID group was 90.7% compared to 83% in the COVID group. Multivariate analyses showed that male gender (odds ratio [OR] = 1.3), income <100 K (OR = 1.9), wards 7 and 8 (OR = 1.9), and pre-COVID group (OR = 0.7) were statistically associated with LTF. There are many factors impacting LTF rates and future follow-up when using the protocols recommended by the Joint Committee on Infant Hearing. This study will be the basis for implementing planned improvement strategies for reducing LTF rates.

Evaluation of hearing screening results of newborns born to SARS-CoV-2 positive pregnant women

Evaluation of hearing screening results of newborns born to SARS-CoV-2 positive pregnant women

Effectiveness of Universal Newborn Hearing Screening at a Government Tertiary Health Care Centre in Central India: A Retrospective Study

Effectiveness of Universal Newborn Hearing Screening at a Government Tertiary Health Care Centre in Central India: A Retrospective Study

P-997. Congenital Cytomegalovirus and Hearing Loss and Response to Treatment with Valganciclovir

Abstract Background Congenital cytomegalovirus (CMV) occurs in about 1 in 200 babies and is the leading non-genetic cause of sensorineural hearing loss (SNHL) in children in the United States. Approximately 50% of children with SNHL secondary to CMV have progression of their hearing loss. Data on the effectiveness of valganciclovir in the treatment of infants with congenital CMV with isolated hearing loss at birth is limited. Methods All newborns who did not pass their newborn hearing screening at birth between 2019-2023 were included and tested for CMV by a nucleic acid test from saliva and if positive confirmed from urine. All infants with CMV detected in urine had a Brainstem Auditory Evoked Response (BAER) test by 2-3 weeks of life and if hearing loss was confirmed, offered treatment with valganciclovir for 6 months. Infants who only had CMV detected in the saliva were not included. Results 204,680 newborns received hearing screens between 2019-2023. 7147 (3.5%) did not pass their hearing screening. 509 (7.1%) had hearing loss confirmed on BAER testing. 46 of the 7147 infants who did not pass their initial hearing screen had CMV detected in saliva and 17 of those had CMV detected in urine. 5 patients never received a urine test and were lost to follow-up. Among 17 cases with confirmed congenital CMV, 9 had confirmed hearing loss, 7 had normal hearing, and one lost to follow-up. 12 of the 17 cases were treated with valganciclovir, 8 with confirmed hearing loss, 3 with normal hearing, and one unknown. Among the 8 treated with hearing loss, 3 had progression of hearing loss, one improved, one was unchanged, and 3 lost to follow-up. Among the 7 with congenital CMV and normal hearing at birth, 3 were treated with valganciclovir and 2 remain with normal hearing with one to be determined. Among the 4 not treated, 3 remain with normal hearing and one was lost to follow-up. Among the 6638 with normal hearing on follow-up, 7-13 had congenital CMV (1 in 511-948). Among the 509 with confirmed hearing loss, there were 9 (1.8%) who had congenital CMV. Conclusion Congenital CMV was found in only 1.8% of newborns with hearing loss and about 0.15% of newborns without hearing loss. Treatment with valganciclovir did not appear to be beneficial in preventing the progression of hearing loss in some newborns but the numbers were too small to reach a conclusion. Disclosures All Authors: No reported disclosures

P-1185. Targeting and Universal Congenital Cytomegalovirus Screening in a Neonatal Intensive Care Unit

Abstract Background Congenital cytomegalovirus (cCMV) infection, confirmed by urine or saliva CMV PCR within 3 weeks of life, affects 0.5 % of live births in the United States. This number varies in different populations, and it is affected by socio-demographic characteristics. In Neonatal Intensive Care Units (NICUs), higher prevalence has been reported in preterm and low birth weight infants, but timing of screening remains a challenge without universal screening because only 10% of cCMV are symptomatic. Regardless of symptoms, infected infants are at increased risk of adverse outcomes such as hearing loss. Thus, we sought to determine the incidence and associated characteristics of cCMV infection using targeting and subsequently universal screening in our NICU population Methods From Feb 1, 2023 to Apr 30, 2024, infants who were admitted at Tampa General Hospital (TGH) NICU and had a CMV PCR testing performed during admission were followed prospectively. Before Feb 28, 2024, cCMV screening was performed only in infants who were symptomatic (IUGR, microcephaly, thrombocytopenia) or failed hearing screen. After that, all infants born preterm &amp;lt; 33 weeks gestational age (GA) and all infants with anticipated NICU stay &amp;gt; 3 weeks were screened for cCMV at admission. Characteristics such as GA, birth weight, and race and ethnicity are recorded in a RedCap database. Descriptive statistics were used Results A total of 715 infants were screened for CMV while hospitalized in the TGH NICU during the study period. Most of the infants (68.2%) were screened after failing newborn hearing screen and only four (0.6%) were screened because of their symptoms. The characteristics of the infants with positive and negative saliva or urine CMV PCR are described in Table 1. Only three (0.4%) infants tested positive for CMV and were confirmed to have cCMV. Two infants with cCMV infection were screened because they were symptomatic Conclusion At TGH NICU, the incidence of cCMV using targeting and universal screening was comparable with the U.S. general population and lower than reported in other NICUs. We plan to perform association when statistically feasible, and compare incidence of cCMV between the targeting and universal screening periods Disclosures Claudia M. Espinosa, MD, MSc, AstraZeneca: Grant/Research Support|Clinetics: Grant/Research Support|Enanta: Grant/Research Support|Gilead: Advisor/Consultant|Jansen &amp; Jansen: Advisor/Consultant|Kentucky Health Rural Association: Honoraria|Medimmune: Grant/Research Support|Melinta: Grant/Research Support|Merck: Grant/Research Support|Sanofi: Advisor/Consultant|Sanofi: Honoraria

Hearing care in low-resourced and humanitarian settings: findings from a pilot study in South Sudan

Objectives This longitudinal experimental study aimed to profile audiometric hearing loss, explore the feasibility and efficacy of low-cost hearing devices, and examine their social and emotional impact on participants in South Sudan, a low-resource humanitarian setting. Design We performed pure tone hearing screenings on adults with self-reported hearing disability, randomly providing eligible participants with one of two inexpensive devices—Asana Pro 800, a non-customizable hearing device fit unilaterally, or the Super Ear SE9000, a hand-held amplifier with headphones given one per individual. Study sample Between October 2022 and January 2023, 142 adults underwent hearing screening at the Juba Teaching Hospital ENT clinic, of whom 19 eligible individuals were provided with hearing devices. Eighteen participants completed the full follow-up period. Results Significant auditory and functional improvements were observed among device users over the study period, alongside self-reported enhanced quality of life. Qualitative data showed improvement in daily activity performance. The provision of low-cost hearing devices appears plausible and impactful. Conclusion Hearing loss poses a significant health issue with complex genetic, environmental, and disease-related causes. Our collaboration initiated accessible, affordable hearing solutions to serve as a framework for hearing healthcare in resource-deprived settings. Further investigation is warranted for scaling this model.

P-1008. Congenital Cytomegalovirus Infection Screening in the Newborn Nursery: Areas for Improvement in the Absence of Standardized Guidelines

Abstract Background Cytomegalovirus (CMV) is the most common viral cause of congenital defects in the U.S. Early identification of congenital CMV (cCMV) infection allows for optimal antiviral treatment which reduces progression of sensorineural hearing loss and improves neurodevelopmental outcomes. There is varying guidance from expert consensus groups ranging from universal screening to selective screening based on clinical features. With conflicting data, many hospitals have no standardized protocol for cCMV screening. This study aims to detail clinical characteristics and outcomes of infants with cCMV in a tertiary medical center prior to implementation of standardized guidelines. Methods This was a retrospective case study of newborns who screened positive for CMV between June 2017-July 2022 at Rainbow Babies &amp; Children’s Hospital in Cleveland, Ohio. 1900 newborns less than 21 days old were tested for CMV during this period, and newborns who screened positive for CMV were included (n=18). Clinical characteristics of the patients were described using median and interquartile range for continuous variables and frequency and percentages for categorical variables. Results The prevalence rate of cCMV at our center is 9.5 per 1000 live births. The most common associated clinical features were small for gestational age (SGA; n=12), microcephaly (n=9), abnormal neuroimaging findings (n=6), and failed newborn hearing screen (n=4). Two patients had isolated SGA, and neither received treatment nor had clinical sequelae. Saliva PCR tests were used for screening with no confirmatory urine testing. 11 patients received oral valganciclovir with documented side effects of transient neutropenia and transaminitis. 33% of newborns had no infectious disease or audiology follow-up. Conclusion Targeted screening practices for cCMV infection in our institution varies between providers. Our center has a prevalence rate slightly above the national average; however, the yield of screening isolated SGA is shown to be low. This study highlights gaps in current cCMV screening including lack of confirmatory urine CMV testing, and infants lost to follow up. System-level interventions including creation of standardized guidelines and provider education are necessary to improve follow-up and outcomes. Disclosures All Authors: No reported disclosures

Can hearing screening criteria at general health checkups be an indirect indicator of frailty and cognitive deficit in the older population? - with prevalence estimates based on updated World Health Organization hearing loss classification.

This study aimed to reestimate the prevalence of hearing loss based on the updated World Health Organization hearing loss classification and investigate whether existing hearing screening criteria could efficiently screen for frailty or cognitive deficit. Data collected from community dwellers aged 40-91 years included 2325 samples. Health checkup hearing screening used were as follows: (A) 30 dB both at 1 and 4 kHz and (B) 30 dB at 1 kHz and 40 dB at 4 kHz were used. For participants aged ≥60 years, frailty according to the modified Cardiovascular Health Study criteria and cognitive deficit defined by a Mini-Mental State Examination score <28 were assessed. Logistic regression was performed to obtain odds ratios for frailty and cognitive deficit. The rates of hearing loss using the updated World Health Organization classification in men were 8.6, 24.1, 54.2, 79.0 and 96.0% in their 40s, 50s, 60s, 70s and 80s and 3.7, 12.7, 36.4, 72.1 and 90.4% in women, respectively. Failing hearing screening using criterion A was associated with an increased risk of frailty, a sex-adjusted odds ratio of 4.136 (95% confidence interval, 2.182-7.838) and an increased risk of cognitive deficit: 1.753 (95% confidence interval, 1.346-2.283). After adjusting for age and sex, the effects on frailty and cognitive deficit were no longer significant. The results were similar when criterion B was used. Because of the high prevalence of hearing loss and the ability to utilize existing devices and methodologies, hearing screening for the elderly should be reviewed. Geriatr Gerontol Int 2025; ••: ••-••.

PROFESSORIAL LECTURE: UTILISING AUDITORY EVOKED POTENTIALS FOR INTERVENTIONS IN CHILDREN WITH AUTISM

Auditory evoked potential (AEP) is a vital tool for audiologists worldwide. It is an objective measure of auditory function, capable of estimating an individual's hearing status and diagnosing disorders within the central auditory nervous system. The most common applications of AEP include estimating hearing thresholds, hearing screenings, and neurodiagnostic evaluations. Less commonly, AEP is used to assess the effectiveness of interventions, predict outcomes of audiological treatments, or forecast the likelihood of certain disorders.

The Otoacoustic Emissions in the Universal Neonatal Hearing Screening: A Scoping Review Update on the African Data (2004 to 2024)

Background: The reported data on African universal neonatal hearing screening (UNHS) practices tend to be quite scarce, despite the developments in hearing screening the last two decades. The objective of this systematic review was (a) to identify the most recent (in a 20-year span) literature information about NHS/UNHS programs in Africa and (b) to provide data on the procedures used to assess the population, the intervention policies, and on the estimated prevalence of congenital hearing loss with an emphasis on bilateral hearing loss cases. Methods: Queries were conducted via the PubMed, Scopus, and Google Scholar databases for the time window of 2004–2024. The mesh terms used were “OAE”, “universal neonatal hearing screening”, “congenital hearing loss”, “well babies”, and “Africa”. Only research articles and review papers were considered as good candidates. The standard English language filter was not used, to identify information from non-English-speaking scientific communities and groups. Results: Data from 15 papers were considered, reflecting the neonatal hearing practices of nine African states. No country-wide NHS programs were reported. The various screening realities are implemented within big urban centers, leaving the residents of rural areas unassisted. For the latter, proposals based on tele-medicine protocols have been suggested. The data on HL prevalence are also incomplete, but the available data refer to rates from 3 to 360 subjects per 1000. These data cannot be taken at face value but within the small sample size context in which they were acquired. Regarding the causes of HL, very few data have been reported; consanguinity is the most attributed factor, at least in the Sub-Saharan African states. For the majority of the programs, no data were reported on hearing loss prevalence/incidence or on any strategies to restore hearing. Conclusions: The information on the African neonatal hearing screening are quite scarce, and it is an urgent need to convince audiologists from the African localized programs to publish their hearing screening data.

Retrospective analysis of prognostic determinants of neonatal hearing loss: an Indian experience in a tertiary care hospital

Background: Childhood hearing impairment is a result of combination of intrauterine environment, perinatal and postnatal factors. The Joint Committee on Infant Hearing (JCIH) has been providing guidelines for early detection of infants with or at risk of hearing loss. In India, UNHSP (Universal neonatal hearing screening program) as a part of NPPCD (National Program for Prevention and Control of Deafness) is a strategy that enables to identify congenital deafness and hearing loss. Methods: Retrospective cross-sectional study was carried out of a database of newborn hearing screening at a tertiary care hospital of New Delhi, India. The screening results, the risk indicators for hearing loss, diagnosis and the prognosis were descriptively analysed. Results: 3640 neonates were included in the study between January 2021 and November 2023. It was observed that, of the 25 babies diagnosed with hearing loss the common risk factors were low birth weight with preterm delivery, hyperbilirubinemia, low birth weight, preterm delivery, NICU stay&gt;05 days and syndromes. Conclusions: UNHSP (Universal Neonatal Hearing Screening Program) aids in early diagnosis of hearing loss using DPOAE (distortion product otoacoustic emission) and BERA (brainstem evoked response audiometry) and significantly reduces the referral rate. Babies with hyperbilirubinemia, preterm delivery and low birth weight have a poor prognosis and are at a higher risk for neonatal hearing loss as per our study. Hearing augmentation in early years of life reduces morbidity and aids better quality of life.

Age of detection of congenital hearing loss in South Africa: A systematic review

Background: Newborn hearing screening is the most important step towards early intervention of congenital or early-onset hearing loss (HL) and has the potential to optimise patient outcomes. Yet, literature on the age of identification of this HL in South Africa (SA) is sparse.Aim: To determine the age of identification of congenital HL from published studies in SA.Setting: The study was conducted in SA.Methods: This was a systematic review conducted during April 2024 – June 2024 across the following databases: PubMed, EBSCO, Web of Science and Scopus. A random effects (RE) model meta-analysis was conducted using STATA version 18. Statistical tests conducted include meta-summary statistics and RE meta-analysis.Results: Ten studies, with a total of 1501 children, were included in this review. The computed Q-test of homogeneity was 5870.97 and the pooled mean age of identification was 30 months (95% confidence intervals [CI]: 19.3–41.3).Conclusion: These findings show that congenital or early-onset HL in SA is identified later than the national and international standards, that is, 1 month of age. These findings are important for future research, priority setting and implementation of strategies to reduce the burden and impact of HL. Future research investigating the barriers to early detection of HL in SA is recommended. Furthermore, the implementation of evidence-based interventions to lower the age of identification of congenital HL to enable its early detection and intervention in this age group is recommended.Contribution: This study highlights the need to strengthen preventative programmes for paediatric HL in SA.

Inpatient Audiologic Services Facilitate Early Hearing Detection.

Infants needing neonatal intensive care unit (NICU) intervention have protracted timelines for diagnosis after not passing their newborn hearing screening despite being at higher risk for congenital hearing loss. The primary aim of this study was to evaluate the outcomes of early hearing detection for infants with a history of NICU admission. The secondary aim was to determine if diagnostic audiology services within the NICU setting accelerated diagnosis and intervention. A retrospective chart review was completed for infants referred for diagnostic audiologic testing from 2018 to 2021 at a tertiary urban-setting children's hospital. After exclusion criteria were applied, 367 infants with NICU history were included in the analysis. Various factors were recorded from electronic medical records. Time to diagnosis was derived and compared across (a) NICU location, (b) insurance type, and (c) race/ethnicity. Analysis of infants with NICU history revealed that 70% of infants had a diagnosis by 3 months corrected age. The level of in-NICU audiologic care did not significantly impact corrected age at diagnosis; however, loss to follow-up (LTFU) rates were higher for NICUs that did not provide in-hospital diagnostic services (10.0%) when compared to the NICU setting with inpatient audiology services (6.8%). In-NICU testing occurred on average 5.7 weeks prior to discharge, expediting diagnosis of hearing status compared to having to wait for an outpatient evaluation after discharge. Timely hearing detection is feasible in the medically complex NICU population. Inpatient audiology diagnostic testing may help reduce LTFU and facilitate early hearing detection and intervention.

Is routine hearing screening necessary in patients with inflammatory bowel disease - a prospective study.

To compare audiological profiling and association of hearing loss in different types of IBD and evaluate the degree of hearing impairment based on duration of illness and age parameters. 120 subjects evaluated at a tertiary centre were divided into 2 groups- Controls and Cases. Cases were sub grouped into Ulcerative colitis (UC) and Crohn's disease based on biopsy. Hearing evaluation was done using PTA and DPOAE. Results were compared between the groups with analysis including duration of illness and age at presentation. Mild hearing loss at 8000Hz was noted in both the subgroups, more so in UC. The median dB loss on PTA was more in the UC group at all the frequencies but was significant only at 1000, 2000, 4000 and 8000Hz. 53(44.1%) of the 120 ears, showed mild hearing loss at 8000Hz on PTA. The median SNR was lower in both subgroups at 8000Hz. At 8000Hz on DPOAE, 80 ears (66.6%) showed absent response which was much higher as compared to PTA findings at this frequency. At 8000Hz, patients with > 5 years duration of illness and those with age > 30 years, showed higher absent DPOAE responses namely 25 ears (83.4%) out of 30 ears and 56 ears (80%) of 70, respectively. UC cases are more susceptible to hearing loss compared to Crohn's disease especially at 8000Hz. DPOAE supersedes PTA as a diagnostic tool for subclinical hearing loss.

ANALYZING RISK FACTORS AND OUTCOMES OF NEONATAL HEARING SCREENING

Objective: Neonatal hearing loss can significantly impact a child's developmental trajectory. This study evaluates the risk factors associated with neonatal hearing impairment and analyzes the outcomes of a hearing screening program at a tertiary care center. Methods: This prospective observational study involved 1175 neonates screened for hearing loss using Otoacoustic Emissions (OAE). Data were collected on high-risk factors such as consanguinity, family history of deafness, ototoxic drug exposure, and low birth weight, and their association with screening outcomes. Results: The prevalence of high-risk factors included consanguinity (13.53%), family history of deafness (0.17%), ototoxic drug intake (0.26%), and low birth weight (19.91%). Of those initially referred for additional testing, 50% were lost to follow-up, and 50% confirmed for further diagnostic evaluation. Associations were noted between consanguinity and referral rates, as well as a strong correlation between family history and referrals. Conclusion: The study highlights the effectiveness of initial neonatal hearing screenings but indicates the need for improved follow-up systems to ensure comprehensive care for all neonates at risk of hearing loss.

ASSESSMENT OF UNIVERSAL NEONATAL HEARING SCREENING: OUTCOMES AND PREVALENCE AT A TERTIARY CARE CENTER

Objective: Early detection of hearing impairment through Universal Neonatal Hearing Screening (UNHS) is crucial for timely intervention. This study assesses the outcomes and prevalence of hearing loss in neonates screened at a tertiary care center. Methods: This prospective observational study involved 1175 neonates born at SDM Medical College and Hospital between December 2019 and November 2020. Neonates underwent initial and, if necessary, repeat hearing screenings using the Otoacoustic Emission (OAE) technique. Data on gender and birth weight distribution were also analyzed to explore demographic correlations with screening outcomes. Results: Of the neonates screened, 99.40% passed the initial hearing test, while 0.60% were referred for further evaluation. Among those referred, 71.43% passed on repeat screening, with 28.57% continuing to show potential hearing issues. The majority of neonates weighed over 2.5 kg, indicating a lower presence of very low birth weight infants in the screened population. Conclusion: The high pass rate in initial screenings demonstrates the effectiveness of the OAE method in a tertiary care setting, though the importance of follow-up testing for those referred remains critical. The study highlights the successful implementation of UNHS and underscores the need for continuous monitoring and adaptation of screening protocols to address all potential risks in neonatal hearing loss.

Development and Beta Validation of an mHealth-Based Hearing Screener (SRESHT) for Young Children in Resource-Limited Countries: Pilot Validation Study

Background The prevalence of hearing loss in infants in India varies between 4 and 5 per 1000. Objective-based otoacoustic emissions and auditory brainstem response have been used in high-income countries for establishing early hearing screening and intervention programs. Nevertheless, the use of objective screening tests in low- and middle-income countries (LMICs) such as India is not feasible. Mobile health (mHealth) solutions have been demonstrated to be a viable option for hearing screening in LMICs. Objective This study aims to develop and beta-validate an affordable hearing screener for children younger than 6 years of age to identify moderately severe or higher degrees of hearing loss. Methods In phase 1, a mHealth-based hearing screener (SRESHT) was developed using a single board computer with wireless commercial headphones and speakers as transducers, which were calibrated according to the standard procedure. Three subjective hearing screening modules were conceptualized and developed for different age groups: (1) behavioral observation audiometry–screening for infants aged from 0 to 1 year; (2) speech spectrum awareness task–screening for children 1 to 3 years old; and (3) speech recognition task–screening for children 3 to 6 years old. Different auditory stimuli for the screening modules were generated and suitability was assessed: (1) noisemakers, animal sounds, and environmental sounds for infants (birth to 1 year old); (2) animal sounds and nonsense syllables for children (1 to 3 years old); and (3) eighteen picturable spondee words for children (3 to 6 years old). In phase 2, the SRESHT screener was beta-validated in children aged below 6 years to establish the agreement between SRESHT modules and the gold-standard procedure in identifying moderately severe and higher degrees of hearing loss. Results Off-the-shelf commercial speakers and headphones were selected and calibrated. On comparison of stimuli for behavioral observation audiometry on 15 children, Noisemaker stimuli were found suitable based on the average minimum response levels. On comparison of different stimuli for speech spectrum awareness task on 15 children, animal sounds were found to be suitable. On familiarity check of 18 spondee words for speech recognition task among 20 children, 12 spondee words had the eligibility cutoff (85%) and a presentation level of 5 dB SL (re-pure tone threshold) was sufficient to achieve 80% psychometric function. In phase 2, a total of 55 children aged 0 to 6 years (31 normal hearing and 24 hearing impairment) underwent SRESHT screening for beta validation. Cohen κ indicated that the overall SRESHT screener had a very good agreement (κ=0.82) with gold-standard audiometric screening for identifying moderately severe and higher degrees of hearing loss. Conclusions The development and beta validation of the SRESHT screener using the selected auditory stimuli showed that the stimuli were suitable for screening children.

Integrated digit in noise test (iDIN) for rapid hearing and cognitive screening: a preliminary exploration.

Hearing and cognitive impairments are common amongst older adults, both affecting communication and are not easy to distinguish from each other. To preliminarily evaluate the efficacy of the integrated Digit in Noise Test (iDIN) for rapid screening of hearing and cognitive functions in older adults. This cross-sectional cohort study was conducted at multiple clinical sites. Data collection occurred in sound-treated booths and quiet rooms at several outpatient clinics and elderly community centres. The study included 107 older adults, aged 58-96, who were long-term residents of Hong Kong and native Cantonese speakers. Participants were selected through convenience sampling. Primary outcomes were the speech reception thresholds (SRTs) for 2-, 3- and 5-digit sequences with forward and 3-digit sequences with backward recall measured on iDIN. Hearing level was assessed using pure-tone audiometry. Cognitive function was assessed using the Hong Kong version of the Montreal Cognitive Assessment (HK-MoCA). The 2-digit and 3-digit SRTs effectively distinguished participants with hearing loss, demonstrating high sensitivity (0.815 and 0.908, respectively) and specificity (0.905 and 0.853, respectively). The SRT3b-3f index effectively discriminated between participants who passed or failed the MoCA, with sensitivities of 0.727 and 0.781, and specificities of 0.885 and 0.787 using the two MoCA scoring methods. No significant correlation was found between SRT3b-3f and hearing levels after adjustment for educational background. iDIN demonstrates significant promise for rapid and effective screening of both hearing and cognitive impairments in older adults.

The digit triplet test for school-age hearing screening: comparing languages, school grades and scoring methods in a large sample

Objective To investigate the reliability of a bilingual school-age hearing screening in four school grades based on the Digit Triplet Test (DTT) in two languages and to investigate three calculation methods for referral values in their ability to detect hearing losses and avoid false-positive results. Design and study sample 3255 children, aged between 10 and 17 years old, were tested during a systematic hearing screening program in a bilingual, French-German area in Belgium. French speaking children were tested with a French DTT, German children were tested with a German DTT. The SRT-values, their stability and measurement error were investigated per grade and language. The number of false-positive results was studied for three referral methods, using additional audiometric data of 71 children. Results Our data showed that reliable results with high stability and a small measurement error can be obtained in only around two minutes per ear. Differences between languages are minimal and grade-specific referral values were necessary. A referral method considering the lowest SNRs in the adaptive staircase reduces the number of false-positive results substantially. Conclusion The DTT versions of different languages can be used reliably in a bilingual school-age hearing screening program when grade-specific, alternative referral methods are implemented.

Feasibility of MAGIC pure tone screening in children aged 3 to 6 years

Objective:To explore the feasibility of the multiple-choice auditory graphical interactive check（MAGIC） screening module in childhood hearing screening in children aged 3 to 6 years. Methods:A hearing screening was conducted on 366 children（732 ears） aged between 3 and 6 years. The screening methods included MAGIC, DPOAE, and acoustic immittance.The cooperation, screening time, pass rate, and correlation of the three screening methods were compared. Results:There was a statistically significant difference in the degree of cooperation among the three screeningmethods（P=0.004）.The MAGIC pure tone screening method was 98.6%, the screening DPOAE was 99.5%,and the acoustic immittance screening was 100%. For the screening duration, the MAGIC pure tone screening method was（116.3±59.1）s, the screening DPOAE was（27.2±19.7）s, and the acoustic impedance screening was（24.6±14.6）s. There was a significant statistical significance differences among the three or two groups（P<0.01）. The passing rates of MAGIC pure tone screening,screening DPOAE and acoustic immittance screening were 64.7%, 65.4%, and 69.3%, respectively, and there was no significant statistical difference among the three or two groups（P>0.05）. There was no significant difference between MAGIC pure tone screening method and screening DPOAE（P=0.827>0.05）, and acoustic impedance（P=0.653>0.05）, while the difference between screening DPOAE and acoustic impedance was statistically significant（P<0.01）. Conclusion:MAGIC pure sound screening method has good feasibility, can comprehensively reflect the hearing level of screened children, and can be promoted for hearing screening in children aged between 3 and 6 years.