美国工作组在听力丧失的新生儿筛查方面没有支持依据
WESTPORT, CT (Reuters Health) - The available scientific evidence is insufficient to recommend for or against routine screening of newborns for hearing loss, the US Preventive Services Task Force announced Tuesday.
The USPSTF, a panel of independent experts, reached its conclusions based on a report by the Evidence-based Practice Center at Oregon Health and Science University, which is supported by the Agency for Healthcare Research and Quality. The report appears in The Journal of the American Medical Association for October 24/31.
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"This is not a recommendation to stop screening, nor is it a recommendation to start screening. It's just an assessment of what evidence we have that supports the practice," Dr. Alfred O. Berg, chair of the task force and chair of family medicine at the University of Washington in Seattle, said in an interview with Reuters Health.
Universal neonatal hearing screening, required in more than 30 states, has led to detection and treatment of hearing loss an average of 6 to 9 months earlier than in the absence of such screening, the task force reports.
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Dr. Mark Helfand, of Oregon Health and Science University, and associates report in JAMA that using criteria prespecified by the USPSTF they could identify no prospective, controlled studies directly examining whether neonatal hearing tests improve speech, language or educational development. Eight recent cohort studies were composed of convenience samples; none had clear criteria for inclusion and none involved blinded assessments.
"From 1% to 3% of newborns will be referred for audiological assessment; over 90% of those referred are false-positives," the authors write. Potential adverse effects of misdiagnosis include parental misunderstanding and anxiety, as well as unfavorable labeling of the child, they note. It is unknown if early intervention strategies, such as hearing aids and use of sign language, can be harmful for those wrongly identified as having hearing loss.
, http://www.100md.com
"Various tests are widely implemented before the evidence is strong [that the tests have a positive effect on outcomes]. We recommend using every opportunity you can find to fill in the evidence base," Dr. Berg said. More specifically, he added, "If you're going to [conduct neonatal screening for hearing], you ought do it in a systematic way so we can gather the evidence necessary to tell whether it makes a difference."
JAMA 2001;286:2000-2010.
-Westport Newsroom 203 319 2700, 百拇医药
The USPSTF, a panel of independent experts, reached its conclusions based on a report by the Evidence-based Practice Center at Oregon Health and Science University, which is supported by the Agency for Healthcare Research and Quality. The report appears in The Journal of the American Medical Association for October 24/31.
, http://www.100md.com
"This is not a recommendation to stop screening, nor is it a recommendation to start screening. It's just an assessment of what evidence we have that supports the practice," Dr. Alfred O. Berg, chair of the task force and chair of family medicine at the University of Washington in Seattle, said in an interview with Reuters Health.
Universal neonatal hearing screening, required in more than 30 states, has led to detection and treatment of hearing loss an average of 6 to 9 months earlier than in the absence of such screening, the task force reports.
, 百拇医药
Dr. Mark Helfand, of Oregon Health and Science University, and associates report in JAMA that using criteria prespecified by the USPSTF they could identify no prospective, controlled studies directly examining whether neonatal hearing tests improve speech, language or educational development. Eight recent cohort studies were composed of convenience samples; none had clear criteria for inclusion and none involved blinded assessments.
"From 1% to 3% of newborns will be referred for audiological assessment; over 90% of those referred are false-positives," the authors write. Potential adverse effects of misdiagnosis include parental misunderstanding and anxiety, as well as unfavorable labeling of the child, they note. It is unknown if early intervention strategies, such as hearing aids and use of sign language, can be harmful for those wrongly identified as having hearing loss.
, http://www.100md.com
"Various tests are widely implemented before the evidence is strong [that the tests have a positive effect on outcomes]. We recommend using every opportunity you can find to fill in the evidence base," Dr. Berg said. More specifically, he added, "If you're going to [conduct neonatal screening for hearing], you ought do it in a systematic way so we can gather the evidence necessary to tell whether it makes a difference."
JAMA 2001;286:2000-2010.
-Westport Newsroom 203 319 2700, 百拇医药