{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:46:11Z","timestamp":1759538771837,"version":"build-2065373602"},"reference-count":12,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Epidemiol Community Health"],"published-print":{"date-parts":[[1992,2]]},"abstract":"<jats:p>STUDY OBJECTIVE--The aims were (1) to evaluate impedance measurements against pure tone audiometry as a screening method for the detection of middle ear changes associated with hearing loss in infant school children; (2) to estimate the costs of the health authority of each method. DESIGN--The study involved two stage screening in which both methods were offered, pure tone audiometry being carried out by school nurses and impedance screening by a doctor. SETTING--18 infant or primary schools in Langbaurgh, Cleveland, UK. PARTICIPANTS--610 previously unscreened infant school children took part in the study. MEASUREMENTS AND MAIN RESULTS--Main outcome measures were the sensitivity, specificity, and predictive value of each screening method, using clinical assessment and action as the validating technique. The sensitivity and the predictive value of a positive test in two stage impedance screening was markedly superior to that of pure tone audiometry. The specificity was similar using the two methods. In addition the impedance methods was more rapid and estimated to consume less resource as a screening procedure than pure tone audiometry. CONCLUSIONS--The superiority of the use of impedance screening established in this study should be confirmed in a subsequent audit carried out purely by school nurses.<\/jats:p>","DOI":"10.1136\/jech.46.1.21","type":"journal-article","created":{"date-parts":[[2008,11,12]],"date-time":"2008-11-12T15:10:54Z","timestamp":1226502654000},"page":"21-25","source":"Crossref","is-referenced-by-count":7,"title":["Evaluation of pure tone audiometry and impedance screening in infant schoolchildren."],"prefix":"10.1136","volume":"46","author":[{"given":"I","family":"Holtby","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D P","family":"Forster","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1992,2,1]]},"reference":[{"article-title":"children: a programme for child health surveillance","author":"Hall DMB, ed. Healthfor all","key":"ref_1","unstructured":"Hall DMB, ed. Healthfor all children: a programme for child health surveillance. Oxford: Oxford University Press, 1989: 60."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1136\/bmj.294.6584.1386","article-title":"Screening for hearing loss in childhood: a study of national practice","volume":"294","author":"Stewart-Brown, S.; Haslum, M.N.","year":"1987","unstructured":"Stewart-Brown S, Haslum MN, Screening for hearing loss in childhood: a study of national practice. BMJ 1987; 294: 1386-8.","journal-title":"BMJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0033-3506(74)80045-4","article-title":"Use of impedance audiometry in schoolchildren","volume":"88","author":"Ferrer, H.P.","year":"1974","unstructured":"Ferrer HP, Use of impedance audiometry in schoolchildren. 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BMJ 1990; 300: 1551-6.","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/0140-6736(90)91524-E","article-title":"Otitis media with effusion in children","volume":"336","year":"1990","unstructured":"Otitis media with effusion in children. Lancet 1990; 336: 23-4.","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3109\/03005368109081420","article-title":"Development of school screening audiometry","volume":"15","author":"Fisch, L.","year":"1981","unstructured":"Fisch L. Development of school screening audiometry. BrJ Audiol 1981; 15: 87-95.","journal-title":"BrJ Audiol"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1093\/oxfordjournals.bmb.a072228","article-title":"secretory otitis media in childhood","volume":"43","author":"R, Maw A.","year":"1987","unstructured":"Maw A R. secretory otitis media in childhood. Br Med Bull 1987; 43: 950-65.","journal-title":"Br Med Bull"},{"key":"ref_11","article-title":"Health management training: a workbook for course organisers. Dusseldorf: Association of Schools of","author":"Hollander, H.; Hazewinkel, A.; Leliefeld, H.","year":"1987","unstructured":"Hollander H, Hazewinkel A, Leliefeld H. Health management training: a workbook for course organisers. Dusseldorf: Association of Schools of Public Health in the European Region, 1987 (Mimeo).","journal-title":"Public Health in the European Region"},{"key":"ref_12","first-page":"215","article-title":"The NHS reforms: conditions for successful change. Health Serv Manage 1989; 85","author":"Forster, D.P.; Hadley, R.","unstructured":"Forster DP, Hadley R. The NHS reforms: conditions for successful change. 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