Is Universal Newborn Hearing Screening More Efficient With Auditory Evoked Potentials Compared to Otoacoustic Emissions?

Introduction and objectives: Cost-effectivity of universal newborn hearing screening programmes is under constant review. In this context, the aim of the present study is to evaluate the performance of brainstem response audiometry (BERA) compared to otoacoustic emissions (OAE) as screening tools. Methods: Observational and retrospective study on a universal screening programme started in 1998. We perform a comparative analysis between two groups of newborns evaluated in consecutive periods of time. We analyze outcome measures of the programme as a measure of effectivity, and dedicated resources to weight the costs. Results: We compare a group of 862 newborns from year 2003, screened with transient evoked OAE with a clinical device, with a group of 2300 newborns from years 2005 and 2006, screened with automated BERA. We find a statistically significant difference in the percentage of pass in the first step, favoring BERA (99.7 % vs 91.8 %; P<. 0005). The median of exploration time with BERA was 276 seconds. Costs evaluation points to a progressively decreasing difference between both tools. Conclusions: There are data indicating that BERA could be more cost-effective as initial screening tool. This advantage should be added to the already known more comprehensive evaluation of the auditory pathway, which could lead to the recommendation of its preferential use in auditory screening programmes.