Medical Referral Patterns and Etiologies for Children With Mild-to-Severe Hearing Loss.

The data came from records and intake forms, so some information was missing, vague, or reported by families. Only 146 of 307 children had radiology reports, so imaging findings apply to the children who were imaged, not to all children in the cohort. Eighty-one of 307 children had no documented referral in five categories, but the study does not say why they were not referred. Referral patterns differed by site, and UNC enrolled mainly from its own health system while UI and BTNRH patients often saw outside providers. Providers were not surveyed, so the indications for each referral were unknown. Family history was unreliable because many forms were left blank, and no child with hearing loss confirmed a negative family history. Children with significant developmental delays were excluded, so the findings may not apply to more complex patients. Analyses of CMV, streptococcus, and bacterial meningitis had too few cases to detect differences, so no association can be ruled out. The study describes medical work-up and etiologies; it does not test whether referrals, imaging, or genetic testing improved speech or language outcomes.

The supplied text does not include an author conflict-of-interest or funding declaration. The article is tagged as supported by NIH extramural research and non-U.S. government research support.

Do not treat the 34.2% abnormal imaging rate as proof that every child with mild-to-severe hearing loss needs imaging. Imaging reports were available for only 146 of 307 children, and the study did not show that referrals or imaging improved speech, language, or audibility outcomes.