Title: 'Targeting Regional Pediatric Congenital Hearing Loss Using a Spatial Scan Statistic'
Track: 1 - EHDI Program Enhancement
Keyword(s): Hearing Loss Spatial Scan
Learning Objectives:
  1. Discuss methods to target cases of congenital hearing loss
  2. Outline the utility of the spatial scan statistic in identifying trends in hearing screening referrals
  3. Outline the utility of the spatial scan statistic in quantifying incidence of congenital hearing loss


Introduction: Universal newborn hearing screening programs have been implemented widely. Audiological testing reporting can inform state agencies and clinicians of children in need of definitive diagnostic testing; however, little research has used this information to localize regions where a high number of children fail newborn hearing screening and where congenital hearing loss is most common. The purpose of this study is to utilize a novel statistical method to identify regions and hospitals with the highest rates of failed infant hearing and permanent congenital hearing loss. Methods: Data on live births and audiological reporting of infant hearing loss results in Kentucky from 2009 to 2011 were analyzed. We used spatial scan statistics to identify high-rate clusters of failed newborn screening tests and permanent congenital hearing loss (PCHL), based on the total number of live births per county. We conducted further analyses on PCHL and failed newborn hearing screening tests, based on birth hospital data and method of screening. ?? Results: We observed four statistically significant (p<0.05) high-rate clusters with failed newborn hearing screenings in Kentucky, including two in the Appalachian region. Hospitals utilizing 2-stage otoacoustic emission testing demonstrated higher rates of failed screening (p=0.009) than those utilizing 2 stage automated auditory brainstem response testing. A significant cluster of high-rate of PCHL was observed in western Kentucky. Five of the 54 birthing hospitals were found to have higher relative risk of PCHL and 2 of those hospitals are located in a very rural region of Western Kentucky within the cluster. ?? Conclusion: This spatial analysis has identified specific regions with high rates of congenital hearing loss and failed newborn hearing screening tests. This method of analysis can be useful in the setting of hearing health disparities to focus efforts on regions facing high incidence of congenital hearing loss.
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Matthew L. Bush, M.D. - Primary Presenter,Author,POC
University of Kentucky Dept. of Otolaryngology
     Credentials: Assistant Professor, Department of Otolaryngology - Head and Neck Surgery
     Other Affiliations: Chief, Veterans Affairs Medical Center, Lexington, KY
      Matthew L. Bush, M.D. is an Assistant Professor in the Department of Otolaryngology – Head and Neck Surgery. He earned his M.D. degree at Marshall University in Huntington, WV in 2003. He completed Otolaryngology residency at the University of Kentucky in 2008 followed by a post-doctoral research fellowship and Neurotology & Cranial Base Surgery fellowship at The Ohio State University (2008-2011). Board certified in Otolaryngology and Neurotology, Dr. Bush’s clinical practice focuses on disorders of hearing and balance, including pediatric cochlear implantation. This clinical practice blends well with Dr. Bush’s research interests, which are directed at assessing and addressing rural pediatric and adult hearing health disparities. A K23 Career Development Award from the NIH National Institute of Deafness and Communication Disorders and a Triological Society Career Development Award supports this research. Recent research has been published in The Journal of Pediatrics, Ear & Hearing, The Laryngoscope, and Otology & Neurotology.

Financial -

Nonfinancial - No relevant nonfinancial relationship exist.
Jay Christian - Author
University of Kentucky College of Public Health
     Credentials: Ph.D. Assistant Professor
      W. Jay Christian, Ph.D. is an epidemiologist in the College of Public health at the University of Kentucky.
Cathy Lester - Author
     Credentials: MSSW
      Cathy graduated in 1985 with a BA in Biology. She taught high school biology and math for then moved to Child Welfare at Home of the Innocents for 6 years and then moved to DCBS in CPS Investigations. She worked in investigations, family court, adoptions, and with medically fragile foster children. She joined the EHDI program at the Commission for Children with Special Health Care Needs in September 2011. As the EHDI Health Program Administrator, she works within KY CHILD and CCSHCN’s database to ensure accuracy of data, assist families and providers with information and programming technical assistance. She has her Master’s degree in Social Work and 35 hours post Master’s work. She has also taught Research and Statistics at Kent School of Social Work and Social Work Practice at Spalding School of Social Work.