Comparison of currently available devices designed for newborn hearing screening using automated auditory brainstem and/or otoacoustic emission measurements

Objective: Suitability in clinical practise of three currently available devices designed for automated newborn hearing screening, one combining evoked otoacoustic emissions (EOAE) and automated auditory brain stem response (AABR), the Echoscreen-TDA from Fischer-Zoth, and two AABR screeners, the Algo 3 from Natus and the Beraphone MB11 from Maico, were tested prospectively. Methods: Transiently evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emissions (DPOAE) were measured in one ear of 150 healthy newborns using the Echoscreen-TDA. Three groups of 50 subjects each were tested additionally for AABR recordings either with Echoscreen-TDA, Algo 3 or Beraphone MB11. Measurements were performed after the second day of life. The following aspects were evaluated: (a) subject–instrumentation interface (b) test time (c) costs (unit price and costs for disposable material) and (d) pass rates. Results: Connecting the subjects to the device was the easiest for EOAE measurements with the Echoscreen-TDA, followed by AABR recordings with the Algo 3 and Echoscreen-TDA and were most difficult with the Beraphone MB11. The median test time on one ear was less than 30 s for EOAE measurements and 4–5 min for AABR recordings. Costs for the equipment and for disposable material were lowest for the Echoscreen-TDA and Beraphone MB11, respectively and highest for the Algo 3. Pass rates were highest with 98% for AABR recordings using the Algo 3 and lowest with 92% for AABR recordings using the Beraphone MB11, but differences were not statistically significant. Conclusions: All tested devices can be used for universal neonatal hearing screening. It was easier to connect the subject to the device and measurements were quicker for OAE than for AABR measurements. Echoscreen-TDA combines the two techniques and had the lowest costs for the AABR equipment. Algo 3 had the highest costs for the equipment and for disposable material, but it was highly reliable, and both ears can be tested simultaneously. Connecting the subject was the most difficult with the Beraphone MB11, but there were no disposable supply costs.