Targeting Regional Pediatric Congenital Hearing Loss Using a Spatial Scan Statistic
Year: 2014
Type: article
Study design: Observational Study
Abstract: In Brief Objectives: Congenital hearing loss is a common problem, and timely identification and intervention are paramount for language development. Patients from rural regions may have many barriers to timely diagnosis and intervention. The purpose of this study was to examine the spatial and hospital-based distribution of failed infant hearing screening testing and pediatric congenital hearing loss throughout Kentucky. Design: Data on live births and audiological reporting of infant hearing loss results in Kentucky from 2009 to 2011 were analyzed. The authors 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. The authors conducted further analyses on PCHL and failed newborn hearing screening tests, based on birth hospital data and method of screening. Results: The authors observed four statistically significant (p < 0.05) high-rate clusters with failed newborn hearing screenings in Kentucky, including two in the Appalachian region. Hospitals using two-stage otoacoustic emission testing demonstrated higher rates of failed screening (p = 0.009) than those using two-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 two of those hospitals are located in a very rural region of Western Kentucky within the cluster. Conclusions: This spatial analysis in children in Kentucky has identified specific regions throughout the state with high rates of congenital hearing loss and failed newborn hearing screening tests. Further investigation regarding causative factors is warranted. 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. Congenital hearing loss (CHL) is a common problem, and timely identification and intervention is paramount for language development. Incidence of congenital hearing loss may vary widely across regions and is difficult to isolate, making targeted interventions difficult to devise and implement. This study utilizes a spatial scan statistic to identify geographic clusters of high incidence of CHL and abnormal early diagnostic testing. Clusters of high incidence of CHL and abnormal screening test were identified within rural regions. These areas traditionally maintain substantial health disparities, and further research should investigate causative factors and methods to address this problem.
Source: Ear and Hearing
Institution: University of Kentucky
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W2334129838