Pediatric Quality Measures in Hearing Screening and Follow-Up

CONTEXT: Quality measures are needed to ensure that children receive timely screening and follow-up for hearing problems. OBJECTIVE: To summarize pediatric quality measures for hearing screening and follow-up. DATA SOURCES: We searched PubMed, Embase, CINAHL, Cochrane Library, and PsycINFO from 2009 to December 7, 2024, including gray literature from governmental and nongovernmental entities. STUDY SELECTION: Systematic reviews, original articles. DATA EXTRACTION: Measure definitions, study characteristics, barriers, and research gaps. RESULTS: We identified 27 hearing screening and 97 follow-up measures, mostly applied to newborns. In total, 9 systematic reviews identified 5 screening and 10 follow-up measures, 13 studies identified 13 screening and 47 follow-up measures, and 12 gray literature sources identified 11 screening and 42 follow-up measures. We found evidence for reliability, validity, usability, and feasibility in 8, 11, 3, and 4 screening measures, respectively, and for 22, 44, 17, and 13 follow-up measures, respectively. Of the follow-up measures, 14 had evidence against feasibility. Additionally, 8 screening and 8 follow-up measures demonstrated improvement in quality-of-care outcomes. Use of measures differed by state, targeted population, and clinician type. Barriers to measure implementation were related to data infrastructure, integration, collection, reporting, and lack of standardization. LIMITATIONS: Searches focused on identifying measures used in the United States. Studies were not designed to assess measure characteristics. CONCLUSIONS: Many pediatric hearing screening and follow-up measures have evidence of reliability, validity, and usability, although feasibility of follow-up measures is a concern. Future research should evaluate data infrastructure and systems for implementing follow-up and standardizing and stratifying screening and follow-up measures.