Title: 'Eliminating the Practice of Rolling up “Switched Ear” Results Increases the Detection of Hearing Loss in UNHS.'
Track: 1 - EHDI Program Enhancement
Keyword(s): rolling up switched ear results, universal newborn hearing screening, repeated automated screens, minimizing false negative results
Learning Objectives:
  1. Increase the awareness of possible false negatives in switched ear results.
  2. Changing UNHS protocols to maximize true positive and minimize false negatives.
  3. Importance of data management and quality review of hearing screen trends and results.


Over the last two decades, universal newborn hearing screening (UNHS) has become the standard of care worldwide. Many successful screening programs adopt protocols with repeated screens inpatient (IP) and/or outpatient (OP) to reduce refers, minimizing false positives. However, there are no established criteria for combining these results into a final pass/refer decision that would enhance sensitivity without compromising specificity (more hearing impaired children with passing results). Within this context “switched ear” results (referred one ear initially and later passed that ear and failed the other) were investigated in a nationwide Pediatrix-UNHS program using IP/OP screens with automated ABR technology. Out of the 2,491,187 babies screened between Jan 2009 and May 2013, 16,043 were referred for diagnostic evaluation (2,395 had switched ear results) and about 90% were tracked successfully. From the tracked evaluations, we maintained a follow-up period for 2 years and obtained diagnostic and/or intervention results which were entered periodically in the Pediatrix data management system. Out of the switched ear results, there were 367 babies with confirmed hearing loss that would have been missed otherwise as “false negatives.” In conclusion, eliminating the practice of rolling up “switched ear results” as a pass/pass would further increase the yield of UNHS positive outcomes, minimize false negatives (hearing impaired with passing results), and keep the refer and false positive rates within an acceptable range.
Presentation: Poster_BrendaSommer_1590.pdf

Handouts: Handout_1590BrendaSommer.ppt
CART: CART Transcription is not Available
Beverly Gail Lim - POC,Primary Presenter
     Credentials: ARNP, AuD
      Gail is VP at Mednax, she is a neonatal nurse practitioner and recieved her doctoral in audiology. She has been an advocate for newborn hearing screening for 25 years and started the Pediatrix NBHS program 20 years ago. The program provides NBHS in 380 hospitals across the US and screens over 750,000 babies each year. She has received recognition from the State of Texas and South Carolina for her work with newborn hearing screen.

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Brenda Sommer - Co-Presenter
Pediatrix Medical Group
     Credentials: Registered Nurse
      Brenda is the Chart Abstractor and Clinical Manager with Pediatrix Medical Group. She is a Registered Nurse and has performed peer review for 12 years for the State of Ohio. She has been providing chart review for Pediatrix for 12 years and facilitates timely tracking and progress of refer infants in the Pediatrix NBHS program toward diagnosis and intervention. She designed and implemented tools and protocols to track refer information including auditory risk factors for hearing loss.

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.
Maria Perez Abalo - Co-Presenter
Pediatrix Medical Group
     Credentials: MD, PhD
      Dr Abalo began UNHS in Cuba she was a Senior Scientist, full time Professor, for the Cuban National Center for Scientific Research, in Havana, Cuba. Dr Abalo has authored several scientific articles about NBHS and screening methodologies. She currently works with Pediatrix NBHS clinical review team.

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Shauna FlowersMorales - Co-Presenter
     Credentials: MS Data Administrator for Pediatrix newborn hearing screen program
      Has been with Pediatrix Newborn Hearing Screen Program for the last 9 years. She generates data management reports for quality assurance and reporting to the hospitals and state EHDI programs.

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