The Efficiency of Automated Auditory Brain Stem Response Test Inclusion in Neonatal Hearing Screening Programs: A Systematic Review

Abstract

Background: One of the developmental abnormalities that may not be readily apparent at birth is congenital hearing loss. Neonates’ universal hearing screening program have been implemented because early hearing loss recognition is advantageous to a child's development. This study aimed to find out the evidence of the efficiency of AABR in neonatal programs of hearing screening in early detection and diagnosis of neonatal hearing loss. Methods: This systematic review study adhered to the PRISMA guidelines during the preparation and other steps according to systematic reviews of intervention Cochrane handbook. After application of inclusion and exclusion criteria to study abstracts yielded 16 articles. Results: We identified 16 studies discussing efficiency of automated auditory brainstem response (AABR) test in neonatal hearing loss screening with a total number of 462917 neonates. The age range across the studies ranged from neonates of hours after birth to infants of 4 months. The pooled estimate of sensitivity of automated auditory brain stem response test was 88.9% (95% CI: [0.767, 0.952]). The pooled estimate of specificity of automated auditory brain stem response test was 94.2% (95% CI: [0.721, 0.990]). The pooled estimate of positive likelihood ratio of automated auditory brain stem response test was 17.050 (95% CI: [3.9, 74.155]). The pooled estimate of negative likelihood ratio of automated auditory brain stem response test was 0.115 (95% CI: [0.069, 0.194]). The AABR was a good hearing screening test with high coverage rate and low referral rate, with sensitivity of 88.9%, specificity of 94.2% and area under the curve of more than 99%. Conclusion: This study concluded that AABR is an efficient screening procedure for hearing loss among neonates with very good sensitivity and excellent specificity. AABR has a high coverage rate and low referral rate.