Kemper and Downs1 presented a cost-effectiveness analysis of 2 methods of identification of permanent congenital hearing loss (PCHL) but chose not to consider the benefits of universal newborn hearing screening (UNHS), leaving their article no more than a cost comparison. This lapse remains a fatal flaw.
Permanent congenital hearing loss is arguably the most common serious congenital anomaly. Strategies other than UNHS fail to identify sufficient proportions of affected children in a timely manner. Targeted high-risk screening can at best identify 59% of children with PCHL.1 Most studies report that fewer than 50% of children with hearing loss have identifiable risk factors.2- 7 In practice, targeted screening programs have done even more poorly,8 which has been our experience in Oregon.
Lahr MB. Universal Newborn Hearing Screening. Arch Pediatr Adolesc Med. 2001;155(3):421-422. doi:10.1001/archpedi.155.3.417