Auditory Brainstem Response (ABR) Testing in Babies

- Annexes

Editorial Independence:

● This guideline was developed without any external funding.

● All the guideline development group members have declared that they do not have any competing interests.

Table 1 Currency

No.	Guideline Name	Year of Publication	The Organization	Age Demography
1	Threshold estimation by the tone evoked auditory brainstem response: A literature meta-analysis	2000	Canadian Journal of Speech-Language Pathology and Audiology BY University of British Columbia	Adult and infant/ child
2	Practice guidelines: Principles of external peer review of auditory electrophysiologic measurements	2018	British Society of Audiology	Newborn
3	Guidelines 9C: Recommended standards for Short latency auditory evoked potentials: American neurophysiological guidelines	2008	American Clinical Neurophysiology Society	Adult, neonates, infants and children
4	Recommended Procedure: Auditory Brainstem Response (ABR) Testing in Babies	2019	British Society of Audiology	Newborn
5	Year 2019 Position Statement: Principles And Guidelines For Early Hearing Detection And Intervention Programs	2019	The Joined Committee On Infant Hearing	Infants
6	Guidelines for the early audiological assessment and management of babies referred from the Newborn Hearing Screening Program: Version 3.1	2013	The UK NHC and NHS screening programs	Newborns

Table 2 Content

	Guideline 1 British Columbia 2000	Guideline 2 BSA 2018	Guideline 3 American Clinical Neurophysiology Society 2008	Guideline 4 BSA 2019	Guideline 5 JCIH 2019	Guideline 6 NHSP 2013
Credibility	7	8	7	9	8	8
Observability	7	8	8	9	8	8
Relevance	8	6	8	9	8	8
Relative advantage	8	8	7	9	8	7
Easy to install and understand	7	7	8	9	8	8
Compatibility	7	8	7	9	8	7
Testability	8	5	7	9	8	8
Total score	48	50	48	72	64	54

Table 3 Quality

Domain	Guideline 1 British Columbia 2000	Guideline 2 BSA 2018	Guideline 3 American Clinical Neurophysiology Society 2008	Guideline 4 BSA 2019	Guideline 5 JCIH 2019	Guideline 6 NHSP 2013
Transparency	A	A	A	A	A	A
Conflict of interest	B	A	NR	A	B	A
Development group	A	A	B	A	A	A
Systematic review	A	B	C	A	A	A
Grading of evidence	B	A	B	A	B	B
Recommendations	A	A	A	A	A	A
External review	B	B	C	A	A	B
Updating	C	A	C	A	A	B

The statement to be adapted: action	Benefits	Risk/Harm
Skin should be gently wiped with (wet) gauze , abrasions avoided	No possibility of skin injury or skin reaction	No risk or harm
Sleep deprivation, feeding, Diaper change in most situations will lead to natural sleep and lessen activity	No possible complications from sedatives No special or additional safety precautions needed	No risk or harm
Thresholds should be measured for at least two frequency audiometric regions: Low frequency thresholds using 0.5khz High frequency thresholds using TP or TB 2 or 4 khz or clicks	Allows low & high frequency threshold assessment for two region audiometric representation Reduces test time	No harm Potential risk of missing mid frequency HL
Criteria for ABR response & threshold: 1-Reproducibilty of at least two response traces: visual and graphic 2-Reproducibility of responses for all intensity i/o function 3-Threshold is the reproducible response at the lowest stimulus intensity reached	Simplified criteria Matches all response descriptions in the selected guideline Lessens confusion Allows clear , easy & unified reporting of results	No harm or risk
Clinician listening check for the RR used at threshold. Reference dBSPLpe/ eq if and when feasible	Psychoacoustic calibration control is feasible and easy and can be routinely done	No harm or risk