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Centers for Disease Control and Prevention

National Center on Birth Defectsand Developmental Disabilities

Centers for Disease Control and Prevention

National Center on Birth Defectsand Developmental Disabilities

How Accurate are Newborn Hearing Screening Rates? How Accurate are Newborn Hearing Screening Rates?

Marcus Gaffney, MPH Denise Green, MPH

Atlanta, GA

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CDC DisclaimerCDC Disclaimer

The findings and conclusions in this presentation have not been formally disseminated by the Centers for Disease Control and Prevention (CDC) and should not be construed to represent any agency determination or policy.

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ObjectiveObjective

Evaluate the accuracy of state reported newborn hearing screening rates.

Identify strategies to help states calculate more accurate rates of hearing screening

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MethodsMethods Analyzed state data for years 2000 – 2004

– Estimated screening data

Source: Directors of Speech and Hearing

Programs in State Health and Welfare

Agencies’ (DSHPSHWA)

– States reported the number of children born

and screened in their state by year

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MethodsMethods

Recalculated screening rates using occurrence birth data – Provided by CDC’s National Center for Health

Statistics (NCHS)

Screening rates based on NCHS occurrence

data were compared to the rates calculated

using the state reported birth data

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Calculation of Hearing Screening Rates

Calculation of Hearing Screening Rates

Original Rate (state birth data)

# Screened

# State reported births

NCHS Rate

# Screened

# NCHS occurrence births

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Results - NationalResults - National

2000 2001 2002 2003 2004

% DSHPSHWA 51.0 65.8 82.2 87.3 91.7

% NCHS 51.2 65.6 80.3 85.4 90.1

Annual Hearing Screening Rates from DSHPSHWA & NCHS Birth Data

2000 - 2004

0.0

20.0

40.0

60.0

80.0

100.0

2000 2001 2002 2003 2004

Year

Per

cen

t S

cree

ned

% Screened (DSHPSHWA)

% Screened (NCHS)

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FindingsFindings

The difference in national screening rates calculated using the # of births reported by states and the NCHS birth data was relatively small. – The screening rates based on the state reported

birth data were on average 1.3% higher than the NCHS derived rates

Larger variations in screening rates were observed among some individual states

Differences in State Screening Rates of 4% or More

Differences in State Screening Rates of 4% or More

States with Differences in Hearing Screening Rates of 4% or Greater

50

60

70

80

90

100

A B C D A E B F G A H I F J E I F

2000 2001 2002 2003 2004Year

Per

cen

t S

cree

ned

DSHPSHWA

NCHS

Summary of Differences in Screening Rates

Summary of Differences in Screening Rates

Difference in Screening Rates Between DSHPSHWA and NCHS Birth Data

0.0 5.0 10.0 15.0 20.0 25.0

ABC

D

AEBF

GAHI

FJ

EI

F

20

00

20

01

20

02

20

03

20

04

Ye

ar

Percent Difference

Difference inScreening rates

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Hearing Screening Benchmarks

Hearing Screening Benchmarks

How do these difference in screening rates affect the number of states who reach the Joint Committee for Infant Hearing (JCIH) screening benchmark of 95%

JCIH 95% Screening BenchmarkJCIH 95% Screening Benchmark

States Screening Below 95% Based on NCHS Occurrent Birth Data

75

80

85

90

95

100

B D A K L F M N G A H I F N E I F

2000 2001 2002 2003 2004

Year

Per

cen

t S

cree

ned

Screening Rates(DSHPSHWA)Screening Rates(NCHS)

States Exceeding the JCIH Benchmark Based on NCHS Data

States Exceeding the JCIH Benchmark Based on NCHS Data

90

95

100

A B C D

2002 2003 2004

State

Per

cen

t S

cree

ned

Screening Rates(DSHPSHWA)

Screening Rates (NCHS)

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Summary of JCIH 95% Screening BenchmarkSummary of JCIH 95% Screening Benchmark

Use of NCHS occurrence birth data changes the number of states reaching the JCIH 95% screening benchmark– The change in percent of states dropping below

95% ranged from 2 – 12%

A very small number of states benefited from the NCHS birth data by having recalculated rates at or above the JCIH 95% benchmark

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DiscussionDiscussion

The difference in national hearing screening rates using the NCHS data is very small

The large variation in screening rates for some individual states may be due to:– Lack of data integration with vital records– States only reporting births that are required to

be screened and not all births by state of occurrence

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ConclusionsConclusions States should consider integrating EHDI data

systems with other appropriate systems– Integration with Vital Records is especially

important. This may allow more accurate birth data to be reported.

NCHS derived screening rates indicates that fewer states are reaching the JCIH 95% screening benchmark than previously estimated

In order to assess the true progress of UNHS states need to report accurate and verifiable data

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QUESTIONS?QUESTIONS?

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Thank you!Thank you!