Author(s)
Hung-Kai Chen, BPharm, MClinPharm
Yanning Wang, MS
Nicole E. Smolinski, PharmD, PhD
Judith C. Maro, PhD
Sonja A. Rasmussen, MD, MS
Almut G. Winterstein, PhD
Patrick J Antonelli, MD, MS
Affiliation(s)
University of Florida
Abstract:
Objective: To evaluate the prevalence of congenital hearing loss (cHL) and timing to cHL identification.
Study Design: Retrospective birth cohort study.
Setting: Merative™ MarketScan® commercial claims database (2005-2023)
Patients: Infants with 5 years of continuous enrollment after birth (2005-2018)
Interventions: None
Main Outcome Measures: Prevalence of cHL and time to cHL identification. We used International Classification of Diagnoses codes and audiometric codes to identify HL in insurance claims data. We assessed time to first HL diagnosis and second confirmatory diagnoses following audiometric testing. We excluded conductive hearing loss and unspecified HL diagnoses associated with otitis media or tympanostomy tubes in the year before first HL diagnosis and 6 months before confirmatory diagnosis.
Results: We included 502,274 infants. Compared to infants with an initial diagnosis in the first year of life, the prevalence of cHL more than doubled when the window for confirmatory diagnoses was expanded from 1 to 5 years (0.18% to 0.39%). When relaxing the requirement for the first diagnosis to be in the first year of life, prevalences doubled again (0.73%). After a peak in early infancy, the distribution of first diagnoses across follow-up remained constant up to age 5. The median time to initial diagnosis was 313 days (interquartile range 37-855) and to audiometry was 590 days (184-1135). The median time between initial and confirmatory diagnosis was 290 days (98-653) and median age at confirmatory diagnosis 982 days (400-1476).
Conclusions: We found a marked increase in the prevalence of cHL with longer windows for confirmatory diagnosis and significant delays between initial and confirmatory diagnosis, extending out to age 5.
Learning Objective: To describe the prevalence of cHL using a large insurance claims database.
Desired Result: Clinicians should remain vigilant in monitoring infants and young children for cHL, well beyond 1 year, potentially leading to earlier referrals for confirmatory testing and intervention.
Level of Evidence: Level III (Cohort and case-control studies)
Indicate IRB or IACUC: Exempt.