{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:34:46Z","timestamp":1790620486420,"version":"4.1.0"},"reference-count":35,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"German Innovation Fund of Germany\u2019s Federal Joint Committee","award":["01NVF18038"],"award-info":[{"award-number":["01NVF18038"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,4,18]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Individuals with intellectual disabilities (ID) often suffer from hearing loss, in most cases undiagnosed or inappropriately treated. The implementation of a programme of systematic hearing screening, diagnostics, therapy initiation or allocation and long-term monitoring within the living environments of individuals with ID (nurseries, schools, workshops, homes), therefore, seems beneficial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The study aims to assess the effectiveness and costs of a low-threshold screening programme for individuals with ID. Within this programme 1050 individuals with ID of all ages will undergo hearing screening and an immediate reference diagnosis in their living environment (outreach cohort). The recruitment of participants in the outreach group will take place within 158 institutions, for example, schools, kindergartens and places of living or work. If an individual fails the screening assessment, subsequent full audiometric diagnostics will follow and, if hearing loss is confirmed, initiation of therapy or referral to and monitoring of such therapy. A control cohort of 141 participants will receive an invitation from their health insurance provider via their family for the same procedure but within a clinic (clinical cohort). A second screening measurement will be performed with both cohorts 1\u2009year later and the previous therapy outcome will be checked. It is hypothesised that this programme leads to a relevant reduction in the number of untreated or inadequately treated cases of hearing loss and strengthens the communication skills of the newly or better-treated individuals. Secondary outcomes include the age-dependent prevalence of hearing loss in individuals with ID, the costs associated with this programme, cost of illness before-and-after enrolment and modelling of the programme\u2019s cost-effectiveness compared with regular care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study has been approved by the Institutional Ethics Review Board of the Medical Association of Westphalia-Lippe and the University of M\u00fcnster (No. 2020-843\u2009f-S). Participants or guardians will provide written informed consent. Findings will be disseminated through presentations, peer-reviewed journals and conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>DRKS00024804.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-070259","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T12:51:54Z","timestamp":1684414314000},"page":"e070259","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Effectiveness and costs of a low-threshold hearing screening programme (\n                    <i>H\u00f6rGeist<\/i>\n                    ) for individuals with intellectual disabilities: protocol for a screening study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0321-8673","authenticated-orcid":false,"given":"Katharina","family":"Schwarze","sequence":"first","affiliation":[{"name":"Institute for Health Care Management and Research, University of Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Mathmann","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics and Paediatric Audiology, University Hospital M\u00fcnster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolin","family":"Sch\u00e4fer","sequence":"additional","affiliation":[{"name":"Department of Special Education and Rehabilitation, Education and Aural Rehabilitation of People who are Deaf or Hard of Hearing, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Brannath","sequence":"additional","affiliation":[{"name":"Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip-Hendrik","family":"H\u00f6hne","sequence":"additional","affiliation":[{"name":"AOK Rheinland\/Hamburg, Dusseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sibel","family":"Altin","sequence":"additional","affiliation":[{"name":"AOK Rheinland\/Hamburg, Dusseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Prein","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics and Paediatric Audiology, University Hospital M\u00fcnster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awa","family":"Naghipour","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics and Paediatric Audiology, University Hospital M\u00fcnster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna Marie","family":"Zielonkowski","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics and Paediatric Audiology, University Hospital M\u00fcnster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Wasmuth","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics and Paediatric Audiology, University Hospital M\u00fcnster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Kanaan","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics and Paediatric Audiology, University Hospital M\u00fcnster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoinette","family":"am Zehnhoff-Dinnesen","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics and Paediatric Audiology, University Hospital M\u00fcnster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Sophia","family":"Schwalen","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics and Paediatric Audiology, University Hospital M\u00fcnster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Schotenr\u00f6hr","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics and Paediatric Audiology, University Hospital M\u00fcnster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Scharpenberg","sequence":"additional","affiliation":[{"name":"Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Schlierenkamp","sequence":"additional","affiliation":[{"name":"Essener Forschungsinstitut f\u00fcr Medizinmanagement - EsFoMed GmbH, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Stuhrmann","sequence":"additional","affiliation":[{"name":"Practice for Otolaryngology, Phoniatrics & Paediatric Audiology, Duesseldorf-Meerbusch, Germany"},{"name":"Phoniatrics and Paediatric Audiology, Head and Neck Surgery, Helios HSK, Wiesbaden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Lang-Roth","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University Hospital Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhittin","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Division of Phoniatrics and Paediatric Audiology, University Medicine Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Diekmann","sequence":"additional","affiliation":[{"name":"Essener Forschungsinstitut f\u00fcr Medizinmanagement - EsFoMed GmbH, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Neumann","sequence":"additional","affiliation":[{"name":"Institute for Health Care Management and Research, University of Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna","family":"Gietmann","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics and Paediatric Audiology, University Hospital M\u00fcnster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Neumann","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics and Paediatric Audiology, University Hospital M\u00fcnster, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"key":"2025121401460378000_13.5.e070259.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2788.2008.01059.x"},{"key":"2025121401460378000_13.5.e070259.2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2788.2003.00453.x"},{"key":"2025121401460378000_13.5.e070259.3","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/j.1468-3148.2005.00265.x","article-title":"Health in people with intellectual disabilities: current knowledge and gaps in knowledge","volume":"18","author":"Schrojenstein Lantman-de Valk","year":"2005","journal-title":"J Appl Res Int Dis"},{"key":"2025121401460378000_13.5.e070259.4","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1016\/S0140-6736(21)00516-X","article-title":"Hearing loss prevalence and years lived with disability, 1990-2019: findings from the global burden of disease study 2019","volume":"397","year":"2021","journal-title":"Lancet"},{"key":"2025121401460378000_13.5.e070259.5","first-page":"252","article-title":"Intellectual disabilities and hearing loss","volume":"33","author":"Herer","year":"2012","journal-title":"Commun Dis Quart"},{"key":"2025121401460378000_13.5.e070259.6","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1111\/jar.12057","article-title":"High prevalence of hearing loss at the special Olympics: is this representative of people with intellectual disability?","volume":"27","author":"Hey","year":"2014","journal-title":"J Appl Res Intellect Disabil"},{"key":"2025121401460378000_13.5.e070259.7","doi-asserted-by":"publisher","DOI":"10.1080\/14992020500376891"},{"key":"2025121401460378000_13.5.e070259.8","doi-asserted-by":"publisher","DOI":"10.1258\/smj.2011.011036"},{"key":"2025121401460378000_13.5.e070259.9","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2788.2001.00350.x"},{"key":"2025121401460378000_13.5.e070259.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00106-004-1205-y"},{"key":"2025121401460378000_13.5.e070259.11","first-page":"318","article-title":"Ear, nose and throat disease profile in children with Down syndrome","volume":"86","author":"Paul","year":"2015","journal-title":"Rev Chil Pediatr"},{"key":"2025121401460378000_13.5.e070259.12","first-page":"87","article-title":"Caracter\u00edsticas otorrinolaringol\u00f3gicas en ni\u00f1os Con trisom\u00eda 21: un estudio de 171 pacientes en El Hospital infantil de M\u00e9xico federico G\u00f3mez","volume":"76","author":"Peraza","year":"2019","journal-title":"Bol Med Hosp Infant Mex"},{"key":"2025121401460378000_13.5.e070259.13","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1007\/s001120050582","article-title":"Seromukotympanon bei neugeborenen MIT down-syndrom","volume":"148","author":"Storm","year":"2000","journal-title":"Monatsschrift Kinderheilkunde"},{"key":"2025121401460378000_13.5.e070259.14","doi-asserted-by":"publisher","DOI":"10.1080\/14992020600920812"},{"key":"2025121401460378000_13.5.e070259.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2004.07.007"},{"key":"2025121401460378000_13.5.e070259.16","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1365-2788.1995.tb00910.x","article-title":"Medical aspects of ageing in a population with intellectual disability: II. hearing impairment","volume":"39","author":"Evenhuis","year":"1995","journal-title":"J Intellect Disabil Res"},{"key":"2025121401460378000_13.5.e070259.17","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1080\/13668259900034051","article-title":"Health targets for people with an intellectual disability","volume":"24","author":"Beange","year":"1999","journal-title":"J Intellect Develop Dis"},{"key":"2025121401460378000_13.5.e070259.18","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.15.1986"},{"key":"2025121401460378000_13.5.e070259.19","doi-asserted-by":"crossref","first-page":"2S17","DOI":"10.3109\/14992020309074639","article-title":"Negative consequences of uncorrected hearing loss -- a review","volume":"42","author":"Arlinger","year":"2003","journal-title":"Int J Audiol"},{"key":"2025121401460378000_13.5.e070259.20","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2010.362"},{"key":"2025121401460378000_13.5.e070259.21","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0b013e31803126b6"},{"key":"2025121401460378000_13.5.e070259.22","doi-asserted-by":"crossref","first-page":"291","DOI":"10.4103\/ipj.ipj_216_20","article-title":"Depression and anxiety in parents of children and adolescents with intellectual disability","volume":"30","author":"Sharma","year":"2021","journal-title":"Ind Psychiatry J"},{"key":"2025121401460378000_13.5.e070259.23","unstructured":"Neumann K . P\u00e4daudiologische diagnostik und therapie bei neurop\u00e4diatrischen sprachassoziierten krankheitsbildern. In: L\u00fccke T , Costard S , Illsinger S , eds. Neurop\u00e4diatrie f\u00fcr die Sprachtherapie. Munich, Germany: Elsevier, 2017: 181\u201396."},{"key":"2025121401460378000_13.5.e070259.24","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/S0196-0709(00)80040-X","article-title":"Performance of multiply handicapped children using cochlear implants","volume":"21","author":"Waltzman","year":"2000","journal-title":"Am J Otolaryngol"},{"key":"2025121401460378000_13.5.e070259.25","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(01)00572-9"},{"key":"2025121401460378000_13.5.e070259.26","doi-asserted-by":"publisher","DOI":"10.1007\/s001060050655"},{"key":"2025121401460378000_13.5.e070259.27","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2788.1996.788788.x"},{"key":"2025121401460378000_13.5.e070259.28","unstructured":"NVAVG (Nederlandse Vereniging voor Artsen voor Verstandelijk Gehandicapten) . Richtlijnen voor diagnostiek en behandeling van slechthorendheid bij verstandelijk gehandicapten [guidelines for diagnostics and treament of hearing loss in peopleperson with an intellectual disability]. 1995. Available: http:\/\/nvavg.nl\/wp-content\/uploads\/2014\/upload\/standaarden\/standaard---1995-02-slechthorendheid.pdf"},{"key":"2025121401460378000_13.5.e070259.29","unstructured":"Svensk Neuropediadrisk F\u00f6rening . Downs syndrom medicinskt v\u00e5rdprogram 0\u201318 \u00e5r 2017. n.d. Available: http:\/\/snpf.barnlakarforeningen.se\/wp-content\/uploads\/sites\/4\/2014\/10\/fjortondowntva.pdf"},{"key":"2025121401460378000_13.5.e070259.30","first-page":"10","article-title":"Audiology and intellectual disability. workshop held at the 13th Congress of the European Federation of audiology societies","volume":"7","year":"2017","journal-title":"J Hear Sci"},{"key":"2025121401460378000_13.5.e070259.31","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp11X561186"},{"key":"2025121401460378000_13.5.e070259.32","unstructured":"Neumann K , Hey C , Baumann U . Eine hohe pr\u00e4valenz von H\u00f6rst\u00f6rungen bei den special Olympics belegt die notwendigkeit von H\u00f6rscreenings f\u00fcr personen MIT geistiger behinderung. In: Wegner M , Schulke H , eds. Kieler Schriften zur Sportwissenschaft. Kiel, Germany: Sport-Thieme GmbH, 2009: 6\u201317."},{"key":"2025121401460378000_13.5.e070259.33","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1396815"},{"key":"2025121401460378000_13.5.e070259.34","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200927060-00007"},{"key":"2025121401460378000_13.5.e070259.35","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-070259","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T09:46:08Z","timestamp":1765705568000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-070259"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":35,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5,18]]},"published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1136\/bmjopen-2022-070259"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-070259","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]}}}