An Evidence-Based Systematic Review on the Diagnostic Accuracy of Hearing Screening Instruments for Preschool- and School-Age Children Purpose The purpose of this article is to conduct an evidence-based systematic review on the accuracy of pure-tone or otoacoustic emission (OAE) screening for identifying hearing loss in preschool- and school-age children. Method A systematic search of the literature published between 1975 and 2013 was conducted. Articles meeting ... Review Article
Review Article  |   June 01, 2015
An Evidence-Based Systematic Review on the Diagnostic Accuracy of Hearing Screening Instruments for Preschool- and School-Age Children
 
Author Affiliations & Notes
  • Beth A. Prieve
    Syracuse University, Syracuse, NY
  • Tracy Schooling
    American Speech-Language-Hearing Association, Rockville, MD
  • Rebecca Venediktov
    American Speech-Language-Hearing Association, Rockville, MD
  • Nicole Franceschini
    American Speech-Language-Hearing Association, Rockville, MD
  • Disclosure: The authors have declared that no competing interests existed at the time of publication. This systematic review was conducted under the auspices of the American Speech-Language-Hearing Association; however, this is not an official position statement of the Association.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. This systematic review was conducted under the auspices of the American Speech-Language-Hearing Association; however, this is not an official position statement of the Association.×
  • Correspondence to Tracy Schooling: tschooling@asha.org
  • Editor and Associate Editor: Larry Humes
    Editor and Associate Editor: Larry Humes×
Article Information
Hearing Disorders / Special Populations / Early Identification & Intervention / School-Based Settings / Review Article
Review Article   |   June 01, 2015
An Evidence-Based Systematic Review on the Diagnostic Accuracy of Hearing Screening Instruments for Preschool- and School-Age Children
American Journal of Audiology, June 2015, Vol. 24, 250-267. doi:10.1044/2015_AJA-14-0065
History: Received October 31, 2014 , Revised February 19, 2015 , Accepted March 1, 2015
 
American Journal of Audiology, June 2015, Vol. 24, 250-267. doi:10.1044/2015_AJA-14-0065
History: Received October 31, 2014; Revised February 19, 2015; Accepted March 1, 2015
Web of Science® Times Cited: 3

Purpose The purpose of this article is to conduct an evidence-based systematic review on the accuracy of pure-tone or otoacoustic emission (OAE) screening for identifying hearing loss in preschool- and school-age children.

Method A systematic search of the literature published between 1975 and 2013 was conducted. Articles meeting the selection criteria were critically appraised for quality. Selection criteria required that behavioral thresholds be measured in children failing the screen and in at least a subset of children passing the screen. Sensitivity and specificity were used to calculate positive and negative likelihood ratios that could be compared between instruments.

Results Eighteen studies were included in the final analysis. There was considerable variability among studies on stimulus levels, response criteria, and definition of hearing loss. Approximately half of positive and negative likelihood ratio pairs for OAEs (52%) and pure-tone screening (45%) were considered suggestive or informative for identifying hearing loss.

Conclusions Both pure-tone and OAE screening can identify hearing loss in preschool- and school-age children. Studies that compared both tools in the same population concluded that pure-tone screening had higher sensitivity than OAE screening and thus was considered the preferred tool. Future research should incorporate standard stimulus levels, response criteria, and definitions of hearing loss.

Acknowledgments
This evidence-based review was supported by the American Speech-Language-Hearing Association's National Center for Evidence-Based Practice in Communication Disorders. We thank Rob Mullen, National Center for Evidence-Based Practice in Communication Disorders director, for his contributions in the preparation of this article.
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