Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts

Background: School-based hearing screening is likely to be the first opportunity to identify childhood hearing loss in South Africa. Criteria for school-based hearing screening requires balancing the targeted degree of hearing loss while ensuring that referral rates are sufficiently low for a cost-e...
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Autor*in:	Faheema Mahomed-Asmail [verfasserIn] De Wet Swanepoel [verfasserIn] Robert H. Eikelboom [verfasserIn]

Format:	E-Artikel
Sprache:	Afrikaans ; Englisch

Erschienen:	2016

Schlagwörter:	School hearing screening Screening protocol Rescreen Screening intensity Referral rate Cost-effectiveness

Übergeordnetes Werk:	In: Health SA Gesondheid: Journal of Interdisciplinary Health Sciences - AOSIS, 2010, 21(2016), C, Seite 96-102
Übergeordnetes Werk:	volume:21 ; year:2016 ; number:C ; pages:96-102

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1016/j.hsag.2015.11.003

Katalog-ID:	DOAJ071292659

Internformat


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520			\|a Background: School-based hearing screening is likely to be the first opportunity to identify childhood hearing loss in South Africa. Criteria for school-based hearing screening requires balancing the targeted degree of hearing loss while ensuring that referral rates are sufficiently low for a cost-effective and sustainable programme. The study aim was to investigate the effect of screening intensity (loudness) levels on the referral rate and to establish the effect of an immediate rescreen in reducing the referral rate. Methods: A within-subject study was conducted in two phases. Phase 1: compared the referral rate in a counterbalanced sequence at screening levels of 20 dB HL, 25 dB HL and 30 dB HL across 1, 2 and 4 kHz for 135 children. Phase 2: determined the effect of an immediate rescreen on referral rate for 337 children screened at 25 dB HL. If a further referral was obtained on rescreen, diagnostic audiometry was subsequently conducted. Results: Referral rate was reduced to 6.7% from 17% when using 25 dB HL as opposed to 20 dB HL as screening intensity. Referral rate was reduced to 4.4% when employing 30 dB HL as screening intensity. An immediate rescreen reduced the overall referral rate by more than one-third. Diagnostic audiometry confirmed that almost half (47%) of the referred children had a hearing loss. Conclusion: A screening intensity of 25 dB HL and immediate rescreen reduces the referral rate significantly and will limit the burden of the screening programme on health care resources.
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allfields	10.1016/j.hsag.2015.11.003 doi (DE-627)DOAJ071292659 (DE-599)DOAJea3518b8fe864e9999c6843b43fe6f2c DE-627 ger DE-627 rakwb afr eng RA1-1270 Faheema Mahomed-Asmail verfasserin aut Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: School-based hearing screening is likely to be the first opportunity to identify childhood hearing loss in South Africa. Criteria for school-based hearing screening requires balancing the targeted degree of hearing loss while ensuring that referral rates are sufficiently low for a cost-effective and sustainable programme. The study aim was to investigate the effect of screening intensity (loudness) levels on the referral rate and to establish the effect of an immediate rescreen in reducing the referral rate. Methods: A within-subject study was conducted in two phases. Phase 1: compared the referral rate in a counterbalanced sequence at screening levels of 20 dB HL, 25 dB HL and 30 dB HL across 1, 2 and 4 kHz for 135 children. Phase 2: determined the effect of an immediate rescreen on referral rate for 337 children screened at 25 dB HL. If a further referral was obtained on rescreen, diagnostic audiometry was subsequently conducted. Results: Referral rate was reduced to 6.7% from 17% when using 25 dB HL as opposed to 20 dB HL as screening intensity. Referral rate was reduced to 4.4% when employing 30 dB HL as screening intensity. An immediate rescreen reduced the overall referral rate by more than one-third. Diagnostic audiometry confirmed that almost half (47%) of the referred children had a hearing loss. Conclusion: A screening intensity of 25 dB HL and immediate rescreen reduces the referral rate significantly and will limit the burden of the screening programme on health care resources. School hearing screening Screening protocol Rescreen Screening intensity Referral rate Cost-effectiveness Public aspects of medicine De Wet Swanepoel verfasserin aut Robert H. Eikelboom verfasserin aut In Health SA Gesondheid: Journal of Interdisciplinary Health Sciences AOSIS, 2010 21(2016), C, Seite 96-102 (DE-627)366929062 (DE-600)2114588-X 20719736 nnns volume:21 year:2016 number:C pages:96-102 https://doi.org/10.1016/j.hsag.2015.11.003 kostenfrei https://doaj.org/article/ea3518b8fe864e9999c6843b43fe6f2c kostenfrei http://www.sciencedirect.com/science/article/pii/S1025984815000320 kostenfrei https://doaj.org/toc/1025-9848 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2016 C 96-102
spelling	10.1016/j.hsag.2015.11.003 doi (DE-627)DOAJ071292659 (DE-599)DOAJea3518b8fe864e9999c6843b43fe6f2c DE-627 ger DE-627 rakwb afr eng RA1-1270 Faheema Mahomed-Asmail verfasserin aut Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: School-based hearing screening is likely to be the first opportunity to identify childhood hearing loss in South Africa. Criteria for school-based hearing screening requires balancing the targeted degree of hearing loss while ensuring that referral rates are sufficiently low for a cost-effective and sustainable programme. The study aim was to investigate the effect of screening intensity (loudness) levels on the referral rate and to establish the effect of an immediate rescreen in reducing the referral rate. Methods: A within-subject study was conducted in two phases. Phase 1: compared the referral rate in a counterbalanced sequence at screening levels of 20 dB HL, 25 dB HL and 30 dB HL across 1, 2 and 4 kHz for 135 children. Phase 2: determined the effect of an immediate rescreen on referral rate for 337 children screened at 25 dB HL. If a further referral was obtained on rescreen, diagnostic audiometry was subsequently conducted. Results: Referral rate was reduced to 6.7% from 17% when using 25 dB HL as opposed to 20 dB HL as screening intensity. Referral rate was reduced to 4.4% when employing 30 dB HL as screening intensity. An immediate rescreen reduced the overall referral rate by more than one-third. Diagnostic audiometry confirmed that almost half (47%) of the referred children had a hearing loss. Conclusion: A screening intensity of 25 dB HL and immediate rescreen reduces the referral rate significantly and will limit the burden of the screening programme on health care resources. School hearing screening Screening protocol Rescreen Screening intensity Referral rate Cost-effectiveness Public aspects of medicine De Wet Swanepoel verfasserin aut Robert H. Eikelboom verfasserin aut In Health SA Gesondheid: Journal of Interdisciplinary Health Sciences AOSIS, 2010 21(2016), C, Seite 96-102 (DE-627)366929062 (DE-600)2114588-X 20719736 nnns volume:21 year:2016 number:C pages:96-102 https://doi.org/10.1016/j.hsag.2015.11.003 kostenfrei https://doaj.org/article/ea3518b8fe864e9999c6843b43fe6f2c kostenfrei http://www.sciencedirect.com/science/article/pii/S1025984815000320 kostenfrei https://doaj.org/toc/1025-9848 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2016 C 96-102
allfields_unstemmed	10.1016/j.hsag.2015.11.003 doi (DE-627)DOAJ071292659 (DE-599)DOAJea3518b8fe864e9999c6843b43fe6f2c DE-627 ger DE-627 rakwb afr eng RA1-1270 Faheema Mahomed-Asmail verfasserin aut Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: School-based hearing screening is likely to be the first opportunity to identify childhood hearing loss in South Africa. Criteria for school-based hearing screening requires balancing the targeted degree of hearing loss while ensuring that referral rates are sufficiently low for a cost-effective and sustainable programme. The study aim was to investigate the effect of screening intensity (loudness) levels on the referral rate and to establish the effect of an immediate rescreen in reducing the referral rate. Methods: A within-subject study was conducted in two phases. Phase 1: compared the referral rate in a counterbalanced sequence at screening levels of 20 dB HL, 25 dB HL and 30 dB HL across 1, 2 and 4 kHz for 135 children. Phase 2: determined the effect of an immediate rescreen on referral rate for 337 children screened at 25 dB HL. If a further referral was obtained on rescreen, diagnostic audiometry was subsequently conducted. Results: Referral rate was reduced to 6.7% from 17% when using 25 dB HL as opposed to 20 dB HL as screening intensity. Referral rate was reduced to 4.4% when employing 30 dB HL as screening intensity. An immediate rescreen reduced the overall referral rate by more than one-third. Diagnostic audiometry confirmed that almost half (47%) of the referred children had a hearing loss. Conclusion: A screening intensity of 25 dB HL and immediate rescreen reduces the referral rate significantly and will limit the burden of the screening programme on health care resources. School hearing screening Screening protocol Rescreen Screening intensity Referral rate Cost-effectiveness Public aspects of medicine De Wet Swanepoel verfasserin aut Robert H. Eikelboom verfasserin aut In Health SA Gesondheid: Journal of Interdisciplinary Health Sciences AOSIS, 2010 21(2016), C, Seite 96-102 (DE-627)366929062 (DE-600)2114588-X 20719736 nnns volume:21 year:2016 number:C pages:96-102 https://doi.org/10.1016/j.hsag.2015.11.003 kostenfrei https://doaj.org/article/ea3518b8fe864e9999c6843b43fe6f2c kostenfrei http://www.sciencedirect.com/science/article/pii/S1025984815000320 kostenfrei https://doaj.org/toc/1025-9848 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2016 C 96-102
allfieldsGer	10.1016/j.hsag.2015.11.003 doi (DE-627)DOAJ071292659 (DE-599)DOAJea3518b8fe864e9999c6843b43fe6f2c DE-627 ger DE-627 rakwb afr eng RA1-1270 Faheema Mahomed-Asmail verfasserin aut Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: School-based hearing screening is likely to be the first opportunity to identify childhood hearing loss in South Africa. Criteria for school-based hearing screening requires balancing the targeted degree of hearing loss while ensuring that referral rates are sufficiently low for a cost-effective and sustainable programme. The study aim was to investigate the effect of screening intensity (loudness) levels on the referral rate and to establish the effect of an immediate rescreen in reducing the referral rate. Methods: A within-subject study was conducted in two phases. Phase 1: compared the referral rate in a counterbalanced sequence at screening levels of 20 dB HL, 25 dB HL and 30 dB HL across 1, 2 and 4 kHz for 135 children. Phase 2: determined the effect of an immediate rescreen on referral rate for 337 children screened at 25 dB HL. If a further referral was obtained on rescreen, diagnostic audiometry was subsequently conducted. Results: Referral rate was reduced to 6.7% from 17% when using 25 dB HL as opposed to 20 dB HL as screening intensity. Referral rate was reduced to 4.4% when employing 30 dB HL as screening intensity. An immediate rescreen reduced the overall referral rate by more than one-third. Diagnostic audiometry confirmed that almost half (47%) of the referred children had a hearing loss. Conclusion: A screening intensity of 25 dB HL and immediate rescreen reduces the referral rate significantly and will limit the burden of the screening programme on health care resources. School hearing screening Screening protocol Rescreen Screening intensity Referral rate Cost-effectiveness Public aspects of medicine De Wet Swanepoel verfasserin aut Robert H. Eikelboom verfasserin aut In Health SA Gesondheid: Journal of Interdisciplinary Health Sciences AOSIS, 2010 21(2016), C, Seite 96-102 (DE-627)366929062 (DE-600)2114588-X 20719736 nnns volume:21 year:2016 number:C pages:96-102 https://doi.org/10.1016/j.hsag.2015.11.003 kostenfrei https://doaj.org/article/ea3518b8fe864e9999c6843b43fe6f2c kostenfrei http://www.sciencedirect.com/science/article/pii/S1025984815000320 kostenfrei https://doaj.org/toc/1025-9848 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2016 C 96-102
allfieldsSound	10.1016/j.hsag.2015.11.003 doi (DE-627)DOAJ071292659 (DE-599)DOAJea3518b8fe864e9999c6843b43fe6f2c DE-627 ger DE-627 rakwb afr eng RA1-1270 Faheema Mahomed-Asmail verfasserin aut Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: School-based hearing screening is likely to be the first opportunity to identify childhood hearing loss in South Africa. Criteria for school-based hearing screening requires balancing the targeted degree of hearing loss while ensuring that referral rates are sufficiently low for a cost-effective and sustainable programme. The study aim was to investigate the effect of screening intensity (loudness) levels on the referral rate and to establish the effect of an immediate rescreen in reducing the referral rate. Methods: A within-subject study was conducted in two phases. Phase 1: compared the referral rate in a counterbalanced sequence at screening levels of 20 dB HL, 25 dB HL and 30 dB HL across 1, 2 and 4 kHz for 135 children. Phase 2: determined the effect of an immediate rescreen on referral rate for 337 children screened at 25 dB HL. If a further referral was obtained on rescreen, diagnostic audiometry was subsequently conducted. Results: Referral rate was reduced to 6.7% from 17% when using 25 dB HL as opposed to 20 dB HL as screening intensity. Referral rate was reduced to 4.4% when employing 30 dB HL as screening intensity. An immediate rescreen reduced the overall referral rate by more than one-third. Diagnostic audiometry confirmed that almost half (47%) of the referred children had a hearing loss. Conclusion: A screening intensity of 25 dB HL and immediate rescreen reduces the referral rate significantly and will limit the burden of the screening programme on health care resources. School hearing screening Screening protocol Rescreen Screening intensity Referral rate Cost-effectiveness Public aspects of medicine De Wet Swanepoel verfasserin aut Robert H. Eikelboom verfasserin aut In Health SA Gesondheid: Journal of Interdisciplinary Health Sciences AOSIS, 2010 21(2016), C, Seite 96-102 (DE-627)366929062 (DE-600)2114588-X 20719736 nnns volume:21 year:2016 number:C pages:96-102 https://doi.org/10.1016/j.hsag.2015.11.003 kostenfrei https://doaj.org/article/ea3518b8fe864e9999c6843b43fe6f2c kostenfrei http://www.sciencedirect.com/science/article/pii/S1025984815000320 kostenfrei https://doaj.org/toc/1025-9848 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 21 2016 C 96-102
language	Afrikaans English
source	In Health SA Gesondheid: Journal of Interdisciplinary Health Sciences 21(2016), C, Seite 96-102 volume:21 year:2016 number:C pages:96-102
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callnumber-first	R - Medicine
author	Faheema Mahomed-Asmail
spellingShingle	Faheema Mahomed-Asmail misc RA1-1270 misc School hearing screening misc Screening protocol misc Rescreen misc Screening intensity misc Referral rate misc Cost-effectiveness misc Public aspects of medicine Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts
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topic_title	RA1-1270 Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts School hearing screening Screening protocol Rescreen Screening intensity Referral rate Cost-effectiveness
topic	misc RA1-1270 misc School hearing screening misc Screening protocol misc Rescreen misc Screening intensity misc Referral rate misc Cost-effectiveness misc Public aspects of medicine
topic_unstemmed	misc RA1-1270 misc School hearing screening misc Screening protocol misc Rescreen misc Screening intensity misc Referral rate misc Cost-effectiveness misc Public aspects of medicine
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title	Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts
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title_full	Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts
author_sort	Faheema Mahomed-Asmail
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author_browse	Faheema Mahomed-Asmail De Wet Swanepoel Robert H. Eikelboom
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title_sort	referral criteria for school-based hearing screening in south africa: considerations for resource-limited contexts
callnumber	RA1-1270
title_auth	Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts
abstract	Background: School-based hearing screening is likely to be the first opportunity to identify childhood hearing loss in South Africa. Criteria for school-based hearing screening requires balancing the targeted degree of hearing loss while ensuring that referral rates are sufficiently low for a cost-effective and sustainable programme. The study aim was to investigate the effect of screening intensity (loudness) levels on the referral rate and to establish the effect of an immediate rescreen in reducing the referral rate. Methods: A within-subject study was conducted in two phases. Phase 1: compared the referral rate in a counterbalanced sequence at screening levels of 20 dB HL, 25 dB HL and 30 dB HL across 1, 2 and 4 kHz for 135 children. Phase 2: determined the effect of an immediate rescreen on referral rate for 337 children screened at 25 dB HL. If a further referral was obtained on rescreen, diagnostic audiometry was subsequently conducted. Results: Referral rate was reduced to 6.7% from 17% when using 25 dB HL as opposed to 20 dB HL as screening intensity. Referral rate was reduced to 4.4% when employing 30 dB HL as screening intensity. An immediate rescreen reduced the overall referral rate by more than one-third. Diagnostic audiometry confirmed that almost half (47%) of the referred children had a hearing loss. Conclusion: A screening intensity of 25 dB HL and immediate rescreen reduces the referral rate significantly and will limit the burden of the screening programme on health care resources.
abstractGer	Background: School-based hearing screening is likely to be the first opportunity to identify childhood hearing loss in South Africa. Criteria for school-based hearing screening requires balancing the targeted degree of hearing loss while ensuring that referral rates are sufficiently low for a cost-effective and sustainable programme. The study aim was to investigate the effect of screening intensity (loudness) levels on the referral rate and to establish the effect of an immediate rescreen in reducing the referral rate. Methods: A within-subject study was conducted in two phases. Phase 1: compared the referral rate in a counterbalanced sequence at screening levels of 20 dB HL, 25 dB HL and 30 dB HL across 1, 2 and 4 kHz for 135 children. Phase 2: determined the effect of an immediate rescreen on referral rate for 337 children screened at 25 dB HL. If a further referral was obtained on rescreen, diagnostic audiometry was subsequently conducted. Results: Referral rate was reduced to 6.7% from 17% when using 25 dB HL as opposed to 20 dB HL as screening intensity. Referral rate was reduced to 4.4% when employing 30 dB HL as screening intensity. An immediate rescreen reduced the overall referral rate by more than one-third. Diagnostic audiometry confirmed that almost half (47%) of the referred children had a hearing loss. Conclusion: A screening intensity of 25 dB HL and immediate rescreen reduces the referral rate significantly and will limit the burden of the screening programme on health care resources.
abstract_unstemmed	Background: School-based hearing screening is likely to be the first opportunity to identify childhood hearing loss in South Africa. Criteria for school-based hearing screening requires balancing the targeted degree of hearing loss while ensuring that referral rates are sufficiently low for a cost-effective and sustainable programme. The study aim was to investigate the effect of screening intensity (loudness) levels on the referral rate and to establish the effect of an immediate rescreen in reducing the referral rate. Methods: A within-subject study was conducted in two phases. Phase 1: compared the referral rate in a counterbalanced sequence at screening levels of 20 dB HL, 25 dB HL and 30 dB HL across 1, 2 and 4 kHz for 135 children. Phase 2: determined the effect of an immediate rescreen on referral rate for 337 children screened at 25 dB HL. If a further referral was obtained on rescreen, diagnostic audiometry was subsequently conducted. Results: Referral rate was reduced to 6.7% from 17% when using 25 dB HL as opposed to 20 dB HL as screening intensity. Referral rate was reduced to 4.4% when employing 30 dB HL as screening intensity. An immediate rescreen reduced the overall referral rate by more than one-third. Diagnostic audiometry confirmed that almost half (47%) of the referred children had a hearing loss. Conclusion: A screening intensity of 25 dB HL and immediate rescreen reduces the referral rate significantly and will limit the burden of the screening programme on health care resources.
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title_short	Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts
url	https://doi.org/10.1016/j.hsag.2015.11.003 https://doaj.org/article/ea3518b8fe864e9999c6843b43fe6f2c http://www.sciencedirect.com/science/article/pii/S1025984815000320 https://doaj.org/toc/1025-9848
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Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts

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