***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Objective To determine whether the benefits of universal newborn hearing screening ( UNHS ) seen at age 8 years persist through the second decade . Design Prospect i ve cohort study of a population sample of children with permanent childhood hearing impairment ( PCHI ) followed up for 17 years since birth in periods with ( or without ) UNHS . Setting Birth cohort of 100 000 in southern Engl and . Participants 114 teenagers aged 13–19 years , 76 with PCHI and 38 with normal hearing . All had previously their reading assessed aged 6–10 years . Interventions Birth in periods with and without UNHS ; confirmation of PCHI before and after age 9 months . Main outcome measure Reading comprehension ability . Regression modelling took account of severity of hearing loss , non-verbal ability , maternal education and main language . Results Confirmation of PCHI by age 9 months was associated with significantly higher mean z-scores for reading comprehension ( adjusted mean difference 1.17 , 95 % CI 0.36 to 1.97 ) although birth during periods with UNHS was not ( adjusted mean difference 0.15 , 95 % CI −0.75 to 1.06 ) . The gap between the reading comprehension z-scores of teenagers with early compared with late confirmed PCHI had widened at an adjusted mean rate of 0.06 per year ( 95 % CI −0.02 to 0.13 ) during the 9.2-year mean interval since the previous assessment . Conclusions The benefit to reading comprehension of confirmation of PCHI by age 9 months increases during the teenage years . This strengthens the case for UNHS programmes that lead to early confirmation of permanent hearing loss . Trial registration number IS RCT N03307358 Object : Congenital bilateral permanent childhood hearing impairment ( PCHI ) impairs communication skills and , in some cases , mental health and employment prospect s. Management of PCHI within the first year of life can alleviate most of its adverse effects . We investigated whether neonatal screening of all babies born in hospital , in addition to the st and ard Health Visitor Distraction Test ( HVDT ) , would increase the rates of early diagnosis . Methods : Between 1993 and 1996 , two teams of four part‐time testers and equipment moved between two pairs of hospitals to achieve four periods with neonatal screening and four without neonatal screening , each of 4‐6 mo duration in each hospital . Babies did or did not undergo neonatal screening dependent on the periods during which they were born . We used a  transient evoked oto‐acoustic emissions ( TEOAE ) test followed , in infants who failed this test , by an automated auditory brainstem response ( AABR ) test on the same day . We referred babies with positive results for audiological assessment . Results : 53 781 infants were included in the trial , including 25609 born during periods of neonatal screening . The neonatal screen achieved 87 % coverage of inborn births , with a false alarm rate of 1.5 % , and an overall yield from the screen of 90 cases of bilateral PCHI ≥ 40dB HTL per 100000 target population , equivalent to 80 % of the expected prevalence of the condition in the population . Seventy‐one more babies with moderate or severe PCHI per 100000 target population were referred before age 6 mo during periods with neonatal screening than during periods without . Early confirmation and management of PCHI were significantly increased . The false‐negative rate of neonatal screening was significantly lower than that of HVDT screening ( 4 % vs 27 % ) . Conclusions : Neonatal screening is effective in identification of congenital PCHI and may be particularly useful for babies with moderate and severe PCHI for whom early management may have the most benefit OBJECTIVES We report results for  newborn hearing screening  in a cohort of children born in the Île-de-France region of France , as part of a national screening program set up by the French national health insurance agency . MATERIAL S AND METHODS A prospect i ve study was performed on neonates undergoing hearing screening by automated auditory brainstem response at 35 dB in maternity departments between 2005 and 2011 . In case of positive findings , a further check was performed ; if this was also positive in one or both ears , the child was referred to the diagnostic center . RESULTS The study recruited 27,885 births ; 96 % of neonates were tested . Retest was positive in 0.84 % of cases . Bilateral hearing loss was diagnosed in 0.63 % of infants . Fifty-nine percent of these had ≥ 1 risk factor . Hearing normalized by end of follow-up in 25 % of cases . Hearing loss was moderate in 59 % of hearing-impaired children , severe in 12 % and profound in 29 % . Mean age at hearing aid fitting ranged from 4 months in profound hearing loss to 11.4 months in moderate hearing loss . In children receiving a cochlear implant , mean age at implantation was 14 months . CONCLUSION Newborn hearing screening is now public policy . It is effective in terms of exhaustiveness , age at diagnosis and early management . Caution is appropriate in the treatment of moderate hearing loss . In case of moderate hearing loss associated with otitis media serosa , transtympanic aerators should be suggested as of the age of 6 months to enable hearing threshold measurement . Hearing aid fitting can then be considered around 9 months of age if hearing has not improved BACKGROUND Congenital permanent childhood hearing impairment ( PCHI ) impairs communication skills and , possibly , mental health and employment prospect s. Management within 1 year of birth can alleviate most of its adverse effects . Neonatal screening for this disorder is feasible but its benefit for all babies is disputed . We investigated whether neonatal screening of all babies born in hospital , in addition to the st and ard health visitor distraction test , would increase the rates of early referral , confirmation , and management . METHODS Between 1993 and 1996 , two teams of four part-time testers and equipment moved between two pairs of hospitals to achieve four periods with neonatal screening and four without neonatal screening , each of 4 - 6 months ' duration . Babies did or did not undergo neonatal screening dependent on during which periods they were born . We used a  transient evoked otoacoustic emissions test  and , in babies who failed this test , an  automated auditory brainstem response test  on the same day . We referred babies with positive results for audiological assessment . FINDINGS 53,781 babies were included in the trial , and 25,609 were born during periods with neonatal screening . Neonatal screening achieved 87 % coverage of births , with a false-alarm rate of 1.5 % , and an overall yield of 90 cases of bilateral PCHI of 40 dB or more relative to hearing threshold level per 100,000 target population , equivalent to 80 % of the expected prevalence of the disorder in the population . 71 more babies with moderate or severe PCHI per 100,000 target population were referred before age 6 months during periods with neonatal screening than during periods without . Early confirmation and management of PCHI were significantly increased . The rate of false-negative results from neonatal screening was significantly lower than that for the distraction test ( 4 vs 27 % p=0.041 ) . INTERPRETATION Neonatal screening is effective in identification of congenital PCHI early and may be particularly useful for babies with moderate and severe PCHI for whom early management may have the most benefit Objective The objective of this study was to describe the demographic data , medical status , and incidence of risk factors for hearing impairment  in the neonatal intensive care unit ( NICU ) and well-baby population s in a multicenter prospect i ve study design ed to assess neonatal hearing impairment and to evaluate factors that might affect neonatal hearing test performance . Design This was a prospect i ve multicenter study funded by the National Institutes of Health-National Institute on Deafness and Other Communication Disorders to evaluate the effectiveness of auditory brain stem response , transient evoked otoacoustic emissions , and distortion product otoacoustic emissions for newborn hearing screening . Research staff at each site obtained informed consent and detailed demographic and medical data , including information on established risk factors for hearing loss on 4478 high-risk infants cared for in the NICU , 2348 infants from the well-baby nurseries with no risk factor , and 353 infants from the well-baby nurseries with risk factors . For follow-up purpose s the sample was divided further to include a subgroup called selects . Selects were either infants from the well-baby nursery who had an established risk factor for hearing impairment ( N = 353 ) or did not pass the neonatal hearing screen protocol ( N = 80 ) . In this study , we focus on the distribution of infants by nursery and risk factors only . Particular effort was made to enroll infants with risk factors for hearing loss in both the NICU and well-baby nurseries . Descriptive analyses are used to describe characteristics of this sample . Results All 10 of the risk factors established by the Joint Committee on Infant Hearing in 1994 were identified in the NICU population . The four most common were ototo-ic medications ( 44.4 % ) , very low birth weight ( 17.8 % ) , assisted ventilation > 5 days ( 16.4 % ) , and low Apgar scores at 1 or 5 min ( 13.9 % ) . In contrast , only si- risk factors were present in the well-baby nurseries : family history ( 6.6 % ) , craniofacial abnormalities ( 3.4 % ) , low Apgar scores ( 2.8 % ) , syndromes ( 0.5 % ) , ototo-ic medications ( 0.2 % ) , and congenital infection ( 0.1 % ) . Conclusion These descriptive risk factor data reflect both the newborn population s at the study sites and the bias for enrolling infants at risk for hearing loss . The high-risk NICU sample reflects the characteristics typically found in graduates of the NICU . The data summarized in this study will be used to assess the relationships between risk factor and hearing test outcome OBJECTIVE To assess the feasibility of implementing a universal neonatal hearing screening programme using distortion product otoacoustic emission detection at a major teaching hospital in Hong Kong . DESIGN Descriptive study and question naire . SETTING . Teaching hospital , Hong Kong . METHODS A total of 1064 infants , together with their mothers , were successfully recruited for the study . The participation rate was 99.3 % . A three-stage hearing screening protocol using distortion product otoacoustic emission detection was adopted . Each of the participating infants was screened on three separate occasions ( day 1 - 4 , day 5 - 14 , and day 21 - 30 after birth ) , irrespective of the test results . A question naire was administered to 364 r and omly selected mothers to determine whether as consumers of the hearing screening service , mothers would find screening desirable . RESULTS Results of the screening demonstrated an incidence of permanent bilateral hearing loss ( > or=40 dB in the better ear ) of 0.28 % . The results also showed that 3.5 % of the screened infants were referred for subsequent diagnostic audiological assessment , including those suspected with unilateral as well as bilateral hearing loss . Data obtained were comparable to other reported results obtained using multi-stage screening protocol s. Taking both the false positive rate and the default rate into consideration , the most appropriate time for screening in this hospital setting appeared to be around day 5 to 14 when infants returned to the hospital 's day centre as out- patients for routine medical follow-up . Since this day centre service is not generally provided by all maternity hospitals in Hong Kong , an alternative time for screening would be around day 21 to 30 when infants could return as out- patients solely for the hearing test . The results of the question naire suggested that most mothers thought a neonatal hearing screening would be desirable ( 91.35 % ) . The majority ( 81.70 % ) indicated a preference for screening either within a few days of birth at the maternity ward prior to discharge from the hospital , or between 5 and 30 days when returning to the hospital as an out-patient . CONCLUSION It was concluded that a universal neonatal hearing screening programme could be readily implemented in a maternity hospital setting in Hong Kong OBJECTIVE To investigate the costs and referral rates of 3  universal newborn hearing screening programs : transient evoked otoacoustic emissions ( TEOAE ) , automated auditory brainstem response ( AABR ) , and a combination , two-step protocol in which TEOAE and AABR are used . STUDY DESIGN Clinical outcomes ( referral rates ) from 12,081 newborns at 5 sites were obtained by retrospective analysis . Prospect i ve activity-based costing techniques ( n = 1056 ) in conjunction with cost assumptions were used to analyze the costs based on an assumed annual birth rate of 1500 births . RESULTS Referral rates differed significantly among the 3 screening protocol s ( AABR , 3.21 % ; two-step , 4.67 % ; TEOAE , 6.49 % ; P < .01 ) , with AABR achieving the best referral rate at discharge . Although AABR had the lowest referral rate at discharge and the highest pre-discharge costs , the total pre- and post-discharge costs per infant screened ( AABR , $ 32.81 ; two-step , $ 33.05 ; TEOAE , $ 28.69 ) and costs per identified child ( AABR , 
    Output:
    
Prevalence is higher in those admitted to NICU .