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Schwarze K, Mathmann P, Schäfer K, Brannath W, Höhne PH, Altin S, Prein L, Naghipour A, Zielonkowski SM, Wasmuth S, Kanaan O, Am Zehnhoff-Dinnesen A, Schwalen AS, Schotenröhr A, Scharpenberg M, Schlierenkamp S, Stuhrmann N, Lang-Roth R, Demir M, Diekmann S, Neumann A, Gietmann C, Neumann K. Effectiveness and costs of a low-threshold hearing screening programme ( HörGeist) for individuals with intellectual disabilities: protocol for a screening study. BMJ Open 2023; 13:e070259. [PMID: 37202136 DOI: 10.1136/bmjopen-2022-070259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
INTRODUCTION Individuals with intellectual disabilities (ID) often suffer from hearing loss, in most cases undiagnosed or inappropriately treated. The implementation of a programme of systematic hearing screening, diagnostics, therapy initiation or allocation and long-term monitoring within the living environments of individuals with ID (nurseries, schools, workshops, homes), therefore, seems beneficial. METHODS AND ANALYSIS The study aims to assess the effectiveness and costs of a low-threshold screening programme for individuals with ID. Within this programme 1050 individuals with ID of all ages will undergo hearing screening and an immediate reference diagnosis in their living environment (outreach cohort). The recruitment of participants in the outreach group will take place within 158 institutions, for example, schools, kindergartens and places of living or work. If an individual fails the screening assessment, subsequent full audiometric diagnostics will follow and, if hearing loss is confirmed, initiation of therapy or referral to and monitoring of such therapy. A control cohort of 141 participants will receive an invitation from their health insurance provider via their family for the same procedure but within a clinic (clinical cohort). A second screening measurement will be performed with both cohorts 1 year later and the previous therapy outcome will be checked. It is hypothesised that this programme leads to a relevant reduction in the number of untreated or inadequately treated cases of hearing loss and strengthens the communication skills of the newly or better-treated individuals. Secondary outcomes include the age-dependent prevalence of hearing loss in individuals with ID, the costs associated with this programme, cost of illness before-and-after enrolment and modelling of the programme's cost-effectiveness compared with regular care. ETHICS AND DISSEMINATION The study has been approved by the Institutional Ethics Review Board of the Medical Association of Westphalia-Lippe and the University of Münster (No. 2020-843 f-S). Participants or guardians will provide written informed consent. Findings will be disseminated through presentations, peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER DRKS00024804.
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Affiliation(s)
- Katharina Schwarze
- Institute for Health Care Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Philipp Mathmann
- Department of Phoniatrics and Paediatric Audiology, University Hospital Münster, Muenster, Germany
| | - Karolin Schäfer
- Department of Special Education and Rehabilitation, Education and Aural Rehabilitation of People who are Deaf or Hard of Hearing, University of Cologne, Cologne, Germany
| | - Werner Brannath
- Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
| | | | | | - Lukas Prein
- Department of Phoniatrics and Paediatric Audiology, University Hospital Münster, Muenster, Germany
| | - Awa Naghipour
- Department of Phoniatrics and Paediatric Audiology, University Hospital Münster, Muenster, Germany
| | | | - Susanne Wasmuth
- Department of Phoniatrics and Paediatric Audiology, University Hospital Münster, Muenster, Germany
| | - Oliver Kanaan
- Department of Phoniatrics and Paediatric Audiology, University Hospital Münster, Muenster, Germany
| | | | - Anna Sophia Schwalen
- Department of Phoniatrics and Paediatric Audiology, University Hospital Münster, Muenster, Germany
| | - Anna Schotenröhr
- Department of Phoniatrics and Paediatric Audiology, University Hospital Münster, Muenster, Germany
| | - Martin Scharpenberg
- Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
| | - Sarah Schlierenkamp
- Essener Forschungsinstitut für Medizinmanagement - EsFoMed GmbH, Essen, Germany
| | - Nicole Stuhrmann
- Practice for Otolaryngology, Phoniatrics & Paediatric Audiology, Duesseldorf-Meerbusch, Germany
- Phoniatrics and Paediatric Audiology, Head and Neck Surgery, Helios HSK, Wiesbaden, Germany
| | - Ruth Lang-Roth
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Muhittin Demir
- Department of Otorhinolaryngology, Division of Phoniatrics and Paediatric Audiology, University Medicine Essen, Essen, Germany
| | - Sandra Diekmann
- Essener Forschungsinstitut für Medizinmanagement - EsFoMed GmbH, Essen, Germany
| | - Anja Neumann
- Institute for Health Care Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Corinna Gietmann
- Department of Phoniatrics and Paediatric Audiology, University Hospital Münster, Muenster, Germany
| | - Katrin Neumann
- Department of Phoniatrics and Paediatric Audiology, University Hospital Münster, Muenster, Germany
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Raut P, Sriram B, Yeoh A, Hee KYM, Lim SB, Daniel ML. High Prevalence of Hearing Loss in Down Syndrome at First Year of Life. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2011. [DOI: 10.47102/annals-acadmedsg.v40n11p493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Introduction: Infants with Down syndrome (DS) are at higher risk of hearing loss (HL). Normal hearing at one year of age plays an important part in language development. An audit was conducted to determine the impact of the newborn hearing screening program on the incidence, type and timing of diagnosis of HL during first year of life. Materials and Methods: Infants with DS were scheduled for Universal Newborn Hearing Screening (UNHS) within 4 weeks of life. If they passed, they had a high-risk screen at 3 to 6 months. They were referred to the otolaryngology department if they did not pass the UNHS or the high-risk screen. Information was obtained from the computerised data tracking system and case notes. Infants born from April 2002 to January 2005 and referred to the DS clinic of our hospital were analysed. Results: Thirty-seven (82.2%) of 45 infants underwent UNHS, of which 12 (32.4%) infants did not pass. Of remaining 33 infants, 27 had high-risk screen done of which 14 (51.8%) did not pass. Twenty-eight infants were referred to the ear, nose, throat (ENT) clinic: 12 from UNHS, 14 from high-risk screens and 2 from the DS clinic. Eleven (39.2%) defaulted follow-up. Fourteen (82.3%) of 17 infants who attended the ENT Clinic had HL. Twelve (85.7%) were conductive, and 2 (14.2%) mixed. Nine (64.2%) had mild-moderate HL and 3 (21%) had severe HL. The mean age of diagnosis was 6.6±3.3 months. All were treated medically, plus surgically if indicated. By 12 months of age, the hearing had normalised in 4 (28.6%) infants and remained the same in 3 (21.4%). Five (35.7%) defaulted follow-up. Thirty-five out of 45 (77.8%) underwent complete hearing screen in the first year of life (UNHS & High-risk screen). Six out of 45 (13.3%) had incomplete screening. Fourteen out of 41 (34.1%) had HL of varying degrees. Four out of 45 (8.8%) did not have any audiological assessment in first year of life. Conclusion: The incidence of HL in the first year of life was high (34.1%). Eighty-five percent were conductive with 64.2% in mild-moderate range. One third of infants hearing normalized after treatment, one third remained unaltered and one third of infants did not attend follow-up. An aggressive approach involving early screening after birth and continued surveillance and early referral to appropriate agencies are essential for establishing timely diagnosis and treatment. Measures to reduce the high default rate during long-term follow-up are needed. Parent education and integrated multidisciplinary follow-up clinic may be useful.
Key words: Deafness, Trisomy, UNHS
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Affiliation(s)
| | | | - Annie Yeoh
- KK Women’s & Children’s Hospital, Singapore
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