国内外新生儿听力筛查指南的质量评估及分析
Review of Domestic and International Guidelines for Neonatal Hearing Screening Quality Assessment and System Analysis
唐梦园;黄丽辉;文铖;赵雪雷;于一丁;李悦;
1:首都医科大学附属北京同仁医院耳鼻咽喉头颈外科北京市耳鼻咽喉科研究所耳鼻咽喉头颈科学教育部重点实验室
摘要【Abstract] Objective To systematically sort out local and international guidelines for neonatal hearing screening, and compare the similarities and differences of relevant information in the guidelines of various countries, and evaluate the quality of the guidelines, in order to provide reference basis for the quality evaluation of universal nerborn hearing screening (UNHS).Methods The UNHS related literature was retrieved from Chinese and English databases and government websites, screened according to the inclusion and exclusion criteria, and the basic information of the inclusion guidelines and UNHS related information were extracted. Four researchers used Appraisal of Guidelines for Research & Evaluation II to comprehensively evaluate a total of 23 items in 6 areas, score a total of 2 items, and calculate the score rate of each field, the average score of overall quality, the number of people recommended to use the guide and the interclass correlation coefficient within the group(ICC). Results Fourteen guidelines were included. Among UNHS related information, all recommended that the normal UNHS process be “primary screening-rescreening-diagnosis-intervention”， and 71.43% of the guidelines recommended that the UNHS process in intensive care unit be “primary screening-diagnosis-intervention”. The recommended guidelines for otoacoustic emission or automatic auditory brainstem response in primary screening and re screening of normal newborns were 57.14% and 50% respectively, and the recommended guidelines for automatic auditory brainstem response in primary screening of newborns in intensive care unit were 78.57%. There were 21.43% of guidelines recommended primary screening before discharge,50.00% recommended rescreening within 1 month, 64.29% recommended diagnosis within 3 months and 71.43% recommended intervention within 6 months. 35.71% and 14. 29% of guidelines recommended primary screening coverage of ≥95% and ≥97% respectively. The referral rate ≤4% was35.71%， and ≤5% was 7.14%. In the quality assessment, the score of field 4 (clarity) was the highest, and the score of field 6 (independence) was the lowest. The guidelines of the United States and the United Kingdom had the highest overall scores, both of which had 6.25 points. The intra group correlation coefficients of 14 guidelines were 0.75 and above. Conclusion Fourteen UNHS guidelines were included in this study. The average score of overall quality was high, suggesting that the overall quality was good. The screening procedure,screening technology. initial screening time,rescreening time,diagnosis time and intervention time of most guidelines are consistent. The American and British guidelines have higher scores, which are recommended to be used as a reference for the quality evaluation of neonatal hearing screening.
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