How Accurate are Newborn Hearing Screening Rates?

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How Accurate are Newborn Hearing Screening Rates?

• Marcus Gaffney, MPH
• Denise Green, MPH

Atlanta, GA
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CDC Disclaimer

• The findings and conclusions in this presentation
  have not been formally disseminated by the
  Centers for Disease Control and Prevention (CDC)
  and should not be construed to represent any
  agency determination or policy.

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Objective

• Evaluate the accuracy of state reported newborn
  hearing screening rates.
• Identify strategies to help states calculate more
  accurate rates of hearing screening

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Methods

• Analyzed state data for years 2000 2004
• Estimated screening data
• Source Directors of Speech and Hearing Programs
  in State Health and Welfare Agencies (DSHPSHWA)
• States reported the number of children born and
  screened in their state by year

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Methods

• Recalculated screening rates using occurrence
  birth data
• Provided by CDCs National Center for Health
  Statistics (NCHS)
• Screening rates based on NCHS occurrence data
  were compared to the rates calculated using the
  state reported birth data

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Calculation of Hearing Screening Rates

• Original Rate (state birth data)
• Screened
• State reported births
• NCHS Rate
• Screened
• NCHS occurrence births

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Results - National
2000 2001 2002 2003 2004
DSHPSHWA 51.0 65.8 82.2 87.3 91.7
NCHS 51.2 65.6 80.3 85.4 90.1
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Findings

• The difference in national screening rates
  calculated using the of births reported by
  states and the NCHS birth data was relatively
  small.
• The screening rates based on the state reported
  birth data were on average 1.3 higher than the
  NCHS derived rates
• Larger variations in screening rates were
  observed among some individual states

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Differences in State Screening Rates of 4 or
More
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Summary of Differences in Screening Rates
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Hearing Screening Benchmarks

• How do these difference in screening rates affect
  the number of states who reach the Joint
  Committee for Infant Hearing (JCIH) screening
  benchmark of 95

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JCIH 95 Screening Benchmark
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States Exceeding the JCIH Benchmark Based on NCHS
Data
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Summary of JCIH 95 Screening Benchmark

• Use of NCHS occurrence birth data changes the
  number of states reaching the JCIH 95 screening
  benchmark
• The change in percent of states dropping below
  95 ranged from 2 12
• A very small number of states benefited from the
  NCHS birth data by having recalculated rates at
  or above the JCIH 95 benchmark

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Discussion

• The difference in national hearing screening
  rates using the NCHS data is very small
• The large variation in screening rates for some
  individual states may be due to
• Lack of data integration with vital records
• States only reporting births that are required to
  be screened and not all births by state of
  occurrence

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Conclusions

• States should consider integrating EHDI data
  systems with other appropriate systems
• Integration with Vital Records is especially
  important. This may allow more accurate birth
  data to be reported.
• NCHS derived screening rates indicates that fewer
  states are reaching the JCIH 95 screening
  benchmark than previously estimated
• In order to assess the true progress of UNHS
  states need to report accurate and verifiable data

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QUESTIONS?
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Thank you!