A comparison of automated auditory brainstem responses and transiently evoked otoacoustic emissions for universal newborn hearing screening.

BACKGROUND: The aim of this study was to compare the performance of automated auditory brainstem responses (a-ABR) and automated transiently evoked otoacoustic emissions (a-TEOAEs). MATERIAL/METHODS: A prospective, case-control study in a group of newborns was performed in a maternity hospital carrying out universal newborn hearing screening. Two groups of full-term newborns were examined. The first group included 50 newborns (100 ears) who underwent: 1) a-TEOAEs, 2) a-ABR, and 3) transiently evoked otoacoustic emissions (TEOAEs). The second group consisted of the same number of newborns who underwent identical testing, but in a different order: 1) a-ABR, 2) a-TEOAEs, and 3) TEOAEs. All a-TEOAE and a-ABR testing was performed using the AccuScreen device and all standard TEOAE testing was performed using the ILO88. The pass-fail results of each method were recorded and compared. RESULTS: a-ABR yielded lower referral rates than the otoacoustic emission tests, but the differences were not statistically significant. Comparison between the two groups of study showed higher "pass" rates in the second group, indicating an order effect. CONCLUSIONS: Either method might be useful in universal newborn hearing screening. However, the lower referral rate obtained by a-ABR and its potential to recognize infants at risk for auditory neuropathy and central pathology should be considered.