Agreement between Human Voice (“Baah”) Test and Otoacoustic Emissions in Screening of Infants for Binaural Hearing Loss

Katrina Anne R. Balmores,1 Charlotte M. Chiong1,2,3 and Erasmo Gonzalo D.V. Llanes1

1Department of Otorhinolaryngology, College of Medicine and
Philippine General Hospital, University of the Philippines Manila
2Newborn Hearing Screening Reference Center, National Institutes of Health,
University of the Philippines Manila
3Philippine National Ear Institute, National Institutes of Health,
University of the Philippines Manila

Objective. To determine the agreement between Otoacoustic Emission and “Baah” tests for detecting binaural hearing loss in infants referred for hearing evaluation in a local community setting.

Method. This is a retrospective review done in a Private Community-based Secondary Specialty Hospital. Bilateral hearing test results of 788 neonates and infants obtained between September 2011 and January 2013 using human voice “BAAH” test and OAE were reviewed from January 2014 to September 2015.

Results. There were 432 males and 356 females (male: female ratio 1.2:1) with a mean age of 11.17 days (range of 0-143 days). Of the 780 infants with bilateral “Pass” using OAE, all were screened as “with response” by “Baah” tests. Five infants with bilateral “refer” results using OAE yielded “no response” on “Baah” test. Sensitivity of ‘Baah’ test was 100%, specificity was 99.5%, with positive predictive value of 62.5%, and negative predictive value of 100%. There was good agreement noted between OAE and “Baah” (kappa=.77, p<.001).

Conclusion. The “Baah” test is a possible alternative to OAE in initially detecting binaural hearing loss in areas where equipment and personnel are limited. Although “Baah” test could only detect 62% of infants with binaural hearing loss and could not detect unilateral hearing loss, infants detected with binaural hearing loss can be immediately referred to centers with more sophisticated equipment.

Key Words. bilateral hearing loss, binaural hearing loss, hearing tests, otoacoustic emissions