Background: The principal factors that decide how deafness affects a child's development are the degree of hearing impairment and the age at which it is diagnosed. A number of factors are thought to increase the risk of hearing impairment: low birth weight, prematurity, perinatal hypoxia and jaundice, among others. The high incidence of deafness in children without risk factors and the introduction of simple new screening tests of high sensitivity and specificity has led many prestigious bodies to recommend universal early detection programmes for deafness rather than screening targeted only at high-risk groups.
Objectives: To compare the long-term effectiveness of a universal neonatal screening and early treatment programme for hearing impairment with: a) screening and treatment only of high-risk neonates and b) opportunistic screening and treatment.
Search strategy: Databases searched were MEDLINE (1966 to 2003), EMBASE (1974 to 2003), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2004) and registers of health technology assessment agencies as well as registers of clinical guidelines.
Selection criteria: Randomised controlled trials comparing universal neonatal screening with either high-risk screening or opportunistic screening for hearing impairment.
Data collection and analysis: Two review authors independently screened the search results to identify suitable trials.
Main results: No studies were identified which fulfilled the inclusion criteria.
Authors' conclusions: The long-term effectiveness of universal newborn hearing screening programmes has not been established to date. There is a need for controlled trials and before and after studies to address this issue further.