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Interdisciplinary approach to design, performance, and quality management in a multicenter newborn hearing screening project

Discussion of the results of newborn hearing screening in Hamburg (Part II)

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Previously presented results of the newborn hearing screening in Hamburg and the perspectives are subsequently discussed. Minimum standards referring a participation of 95% of the neonates and a fail rate of less than 4% hearing-impaired children at the primary screening are fulfilled in Hamburg. Systematic screening of newborn hearing by an interdisciplinary approach provides early identification and intervention for children with permanent unilateral and bilateral hearing loss. But a newborn hearing screening on a voluntary basis alone cannot be maintained in the long run. Further, an anonymous data collection is not sufficient in regard to an uninterrupted tracking of conspicuous and unscreened neonates. A lost-to-follow-up rate of 31.3% at primary screening in Hamburg is much too high and emphasizes the need for a public health approach to a population-based newborn hearing screening with an elaborate and name-based tracking system. The legislation and implementation of a nationwide newborn hearing screening program in Germany and the association of German newborn hearing screening centers are highlighting long efforts of hearing professionals. But the implementation of a newborn hearing screening only makes sense if there exists an efficient tracking system. Sad to say, we are still a long way from the implementation of such a tracking system.

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The project received partial funding from the Ministry for Social and Family Affairs and the Ministry of Environment and Health in the first 2 years; the subsequent financing of the part-time jobs was supplied by funds donated to the “Hamburg working group for hearing screening of newborns registered association” (Hamburger Arbeitskreis für Hörscreening bei Neugeborenen, eingetragener Verein” (H.A.H.N. e.V.)). From August 2008 to January 2009, financing was supplied by the Social and Health Authority of Hamburg. None of the sponsors was involved in the study design, collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.

Training support was received from H.A.H.N. e.V. The authors are grateful to the staff and management of the participating hospitals, pediatricians, and pediatric audiologists without whom this project would have been unsuccessful. We thank each professional who identified children for screening.

We thank Professor Dr. med. Antoinette am Zehnhoff-Dinnesen, director of the Department of Phoniatrics and Pediatric Audiology, University of Münster, Germany, and Professor Dr. Katrin Neumann, director of the Department of Phoniatrics and Pediatric Audiology, University of Frankfurt, Germany as the main initiators of the new association of German NHS centers.

We thank Dr. Axel von der Wense, chairman of the HAHN eV and Kai Uus (MD, Ph.D.), program director of Audiology (School of Psychological Sciences, University of Manchester, UK) for their valuable comments. We thank Peter Boettcher, project manager of the newborn hearing screening in Hessen, Germany, Dr. Kurt Buser, Department of Epidemiology and Social Medicine, Hannover Medical University, Dr. Uta Nennstiel-Ratzel and Dr. Inken Brockow, Screening Center in the Bavarian State Office for Health Care and Safe Quality of Foods, and PD Dr. Wafaa Shehata-Dieler, Department of Otolaryngology-Head and Neck Surgery, University of Würzburg, Germany, for the sharing of further data from their newborn hearing screenings. We thank Professor Reinhard G. Matschke (Hannover, Germany) for support and advice. We thank PD Dr. Mark Praetorius, Department of Otolaryngology, University of Heidelberg, Heidelberg, Germany for information about the new association of German NHS centers including program, initiatives, and targets. We thank Dr. Gabriella Tognola, Istituto di Igegneria Biomedica CNR, Milano, Italy for providing the European screening data (2003) for our discussion.

Conflict of interest

None of the sponsors was involved in the study design, collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication. Neither the authors nor their departments have received any financial support from any industry or other external source related to the material discussed in this manuscript.

Disclosure of financial interest

The responsible author and coauthors have never received any financial support belonging to the presented investigation.

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Correspondence to Anna-Katharina Rohlfs.

Additional information

M. Hess and T. Wiesner are representatives of all members of the “Hamburg working group for hearing screening of newborns registered association” (Hamburger Arbeitskreis für Hörscreening bei Neugeborenen, eingetragener Verein” (H.A.H.N. e.V.)).

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Rohlfs, A., Wiesner, T., Drews, H. et al. Interdisciplinary approach to design, performance, and quality management in a multicenter newborn hearing screening project. Eur J Pediatr 169, 1453–1463 (2010). https://doi.org/10.1007/s00431-010-1229-0

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  • Interdisciplinary approach
  • Multicenter newborn hearing screening
  • Screening and fail rate
  • Lost to follow-up
  • Diagnosis and therapeutic intervention of hearing loss
  • Unilateral and bilateral hearing loss