How Accurate are Newborn Hearing Screening Rates? Marcus Gaffney, MPH Denise Green, MPH Atlanta, GA

CDC 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.

Objective Evaluate the accuracy of state reported newborn hearing screening rates. Identify strategies to help states calculate more accurate rates of hearing screening

Methods 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

Methods 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

Calculation of Hearing Screening Rates Original Rate (state birth data) # Screened # State reported births NCHS Rate # NCHS occurrence births

Results - 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

Findings 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

Summary of Differences in Screening Rates

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 Benchmark

States Exceeding the JCIH Benchmark Based on NCHS Data

Summary 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

Discussion 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

Conclusions 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

QUESTIONS?

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