Mapping and documenting existing hearing screening provision

By Allison Mackey and Inger Uhlén

EUSCREEN hearing questionnaire evaluation

Country representatives from almost all European countries and a number of non-European countries have responded to the Questionnaire, regarding hearing screening questions. In order to ensure accurate input to the model, an extensive validation procedure was carried out on all data provided by each Country Representative to the questionnaire for the 42 countries/regions, including all European countries with sufficiently submitted answers (described below). The validation procedure resulted in inconclusive data of varying degree across most countries/regions. Inconclusive answers were addressed with clarification questions to the Country Representatives, via correspondence with our partners in Rotterdam, who are the central point of contact for Country Representatives.

In total, some clarification of varying degree was required for 39 countries/regions out of the total 42 that underwent validation. Answers have been received back by 28 countries/regions. We are awaiting clarification from some countries/regions. Reports have now been finalized for 28 countries/regions and returned to the country representatives.

Validation procedure

The procedure has been as follows:

  • Each answer was classified into descriptive, outcome, or cost.
  • In respect to the Reliability Score provided by the Country Representative, each corresponding answer was qualified as being an approximation (i.e., roughly estimated, guessed) or determination (i.e., a known fact or a calculation based on a source).
  • Each answer was internally cross-checked to repeated or similar questions to ensure internal answer validity.
  • When two Country Representatives have responded to the questionnaire, each answer was cross-checked between County Representatives.
  • A literature review was performed, including grey literature, specific to the country or region under evaluation. Any and all external material relating to the hearing screening programme was accumulated. Any literature published in a language other than English was translated.
  • All source material provided from the Country Representatives on the screening programmes was translated via Google Translate when necessary and reviewed.
  • All answers with corresponding source material were cross-checked with the information provided in that source.
  • Answers marked for follow-up clarification were those that were,
    • discrepant with other answers provided.
    • discrepant with answers provided by a secondary Country Representative
    • discrepant from their source material
    • discrepant from externally acquired material
    • classified as outcome or cost and have been calculated or taken from a source that is not provided

From this procedure, answers that were verified via internal and external consistency were considered valid and written into the Country Report. In cases where validity remains in question, clarification questions were posed to the Country Representative.

Clarification answers received back from the Country Representatives underwent the validation procedure 1-7. In cases where discrepancy could not be resolved, this was indicated in the final Country Report. In cases where data could not be verified via a source, this was indicated in the final Country Report.

Assessment of quality outcomes

From the validated EUSCREEN questionnaire answers, preliminary data analysis has been carried out on the use of quality outcome measures across neonatal hearing screening programmes in Europe. Preparations are being made to disseminate the data in Poznań, Poland at the meeting for Country Representatives and EUSCREEN partners in March 2019.

Inger Uhlén, MD, PhD is a Senior consultant and Head of Pediatric Audiology at the Karolinska University Hospital and PI for the Karolinska Institutet partnership in EUScreen.

Allison Mackey has a Masters in Audiology and is a doctoral student at Karolinska Institutet for the EUScreen project.

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