Early Identification, Tracking, and Early Intervention of Confirmed, Permanent Childhood Hearing Loss, Georgia, 2019–2023
Abstract
Background: Permanent childhood hearing loss (PCHL) in children under 6 years old is a neurologic emergency reportable to the Georgia Department of Public Health (DPH). Within DPH, Children 1st (C1st) is a screening and referral program involved in early identification of PCHL cases, Early Hearing Detection and Intervention (EHDI) tracks confirmed cases, and Babies Can’t Wait (BCW) provides early intervention to cases. However, not all cases identified by C1st or BCW are true (confirmed) PCHL cases. This study measured the proportion of those identified by C1st or BCW who were true PCHL cases according to EHDI, the gold standard, in Georgia resident children born 2019–2023. Methods: PCHL cases reported to EHDI or C1st were deduplicated and matched using SAS. BCW data were queried using SQL for cases with ICD-10-CM diagnosis codes H90.XX or H91.XX indicating PCHL. These were matched to cases identified by EHDI. Cases identified by both EHDI and C1st or BCW were defined as true positives (TP), and cases identified by C1st or BCW, but not EHDI, were false positives (FP). Positive predictive value (PPV) was calculated as TP/(TP+FP) x 100 to determine the proportion of cases identified by C1st or BCW who were TP compared to EHDI. Results: From 2019–2023, EHDI confirmed 1,453 PCHL cases. Of 1,421 cases identified by C1st, 992 were TP (PPV=69.8%). Of 681 cases identified by BCW, 581 were TP (PPV=85.3%). Conclusion: C1st’s lower PPV reflects its gatekeeping role in early identification of at-risk children for PCHL. Conversely, BCW’s higher PPV indicates referral of mostly confirmed PCHL cases, while fewer than those identified by C1st or EHDI, to BCW. These differences highlight the need to enhance coordination among the three programs to ensure all confirmed PCHL cases are identified and receive early intervention to support their language and literacy development.
Keywords
Permanent childhood hearing loss, reportable condition, positive predictive value, early identification, early intervention
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Early Identification, Tracking, and Early Intervention of Confirmed, Permanent Childhood Hearing Loss, Georgia, 2019–2023
Background: Permanent childhood hearing loss (PCHL) in children under 6 years old is a neurologic emergency reportable to the Georgia Department of Public Health (DPH). Within DPH, Children 1st (C1st) is a screening and referral program involved in early identification of PCHL cases, Early Hearing Detection and Intervention (EHDI) tracks confirmed cases, and Babies Can’t Wait (BCW) provides early intervention to cases. However, not all cases identified by C1st or BCW are true (confirmed) PCHL cases. This study measured the proportion of those identified by C1st or BCW who were true PCHL cases according to EHDI, the gold standard, in Georgia resident children born 2019–2023. Methods: PCHL cases reported to EHDI or C1st were deduplicated and matched using SAS. BCW data were queried using SQL for cases with ICD-10-CM diagnosis codes H90.XX or H91.XX indicating PCHL. These were matched to cases identified by EHDI. Cases identified by both EHDI and C1st or BCW were defined as true positives (TP), and cases identified by C1st or BCW, but not EHDI, were false positives (FP). Positive predictive value (PPV) was calculated as TP/(TP+FP) x 100 to determine the proportion of cases identified by C1st or BCW who were TP compared to EHDI. Results: From 2019–2023, EHDI confirmed 1,453 PCHL cases. Of 1,421 cases identified by C1st, 992 were TP (PPV=69.8%). Of 681 cases identified by BCW, 581 were TP (PPV=85.3%). Conclusion: C1st’s lower PPV reflects its gatekeeping role in early identification of at-risk children for PCHL. Conversely, BCW’s higher PPV indicates referral of mostly confirmed PCHL cases, while fewer than those identified by C1st or EHDI, to BCW. These differences highlight the need to enhance coordination among the three programs to ensure all confirmed PCHL cases are identified and receive early intervention to support their language and literacy development.
