Korean J Pediatr.  2017 Nov;60(11):353-358. 10.3345/kjp.2017.60.11.353.

Hearing loss screening tool (COBRA score) for newborns in primary care setting

• Poonual W
• Navacharoen N
• Kangsanarak J
• Namwongprom S
• Saokaew S

• KMID: 2396604
• DOI: http://doi.org/10.3345/kjp.2017.60.11.353

Abstract

PURPOSE
To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool.
METHODS
This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score.
RESULTS
Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66).
CONCLUSION
A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

Keyword

Hearing loss; Screening tool; Newborns; Primary care

MeSH Terms

Birth Weight
Child
Cohort Studies
Elapidae
Evoked Potentials, Auditory, Brain Stem
Hearing Loss*
Hearing Loss, Sensorineural
Hearing*
Humans
Infant
Infant, Newborn*
Joints
Mass Screening*
Parents
Primary Health Care*
Prospective Studies
Risk Factors
ROC Curve
Tertiary Care Centers
Thailand