Looking at the variations in catching hearing loss

Article

Catching hearing loss early is key to helping a child achieve optimal outcomes. However, a new report examines the variations that can occur for diagnosing and treating.

The early identification and utilization of intervention for pediatric hearing loss is incredibly important for not only a child’s language development but the child’s future academic achievement. A report looks at the variation that can occur in the diagnostic workup as well as management of pediatric sensorineural hearing loss.1

The researchers did a cross-sectional study that used the Optum claims database to identify children with pediatric sensorineural hearing loss between January 2008 and December 2018. The diagnostic tools examined included genetic testing, magnetic resonance imaging, computed tomography, electrocardiogram, and cytomegalovirus testing. Cochlear implant, billed hearing aid services, and speech-language pathology were the reported interventions.

A total of 53,711 patients with pediatric sensorineural hearing loss who were an average age of 7.3 years were studied. A majority of the patients were male (29,976) and white (33,441). Sixty percent of the children went to see a general otolaryngologist and 7573 of the children were seen by a pediatric otolaryngologist. In this group, 14,657 children were given a diagnostic workup and 13,482 children were given some form of intervention. During the study period, the use of computed tomography decreased (odds ratio, 0.93 per year; 95% CI, 0.92-0.94) whereas genetic testing increased during the same period (odds ratio, 1.22 per year; 95% CI, 1.20-1.24). Following adjustment, the researchers found that children who went to pediatric otolaryngologists and geneticists had the highest odds of being given a diagnostic workup and intervention. Additionally, economic disparities and racial/ethnic characteristics were found to affect the use of most forms of diagnostic workup and intervention.

The investigators concluded that disparities exist in who receives a diagnostic workup or intervention for pediatric sensorineural hearing loss, which indicates an urgent need to standardize when diagnostic workups are done and the interventions used. They suggested increased education to tackle the issue.

Reference

1. Qian Z, Chang K, Ahmad I, Tribble M, Cheng A. Use of diagnostic testing and intervention for sensorineural hearing loss in US children from 2008 to 2018. JAMA Otolaryngology–Head & Neck Surgery. December 30, 2020. Epub ahead of print. doi:10.1001/jamaoto.2020.5030

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Juanita Mora, MD
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