Neonatal Hearing Rescreening in a Second-Level Hospital: Problems and Solutions

Round 1

Reviewer 1 Report

Authors have inventoriezed a large population of neonatel screenings and looked for burdens and irregulairties that have relevance to report in this journal.

First of al I have to say that the screenening protocol ion this country is already complex to starts with so I am not surprized that it has flwas and drawbacks. The protocol divides children into with and without risk factors whcich I find already wrong because deafness can occur even without risk factors and therefor you do a national screening..

Then there are so many contact moments already in the planning of the screening protocol. I can understand now the term "rescreening". I  actually think this is not good terminology. the screening happens once and after that is substantiating either the hering los and finding a cause or proving that the screening was wron. Sometimes screening protocols can be too stringent : have a look at Versteppe et al. anal;yses of congential hearingloss after neonatals screening in Frontiers pediatrics. here also burdens of screenings are discussed.

I think the data  here are relevant but authors should also elobarate on the screening strategy on ots own: it could be better and they could state that based on the data on delay an losses to follow up: looks like they shoudl go to one uniform screening protocol for all children (with and without risk fators) and less screening but immediate refereal perhaps. it is a missed chance not to discuss this

also the manuscript could be les wordy in descibing the message so some enlish correction coudl help escpeically the word rescreening is not appropiate

 

 

Table 1 is not as informative as mentioning the cpverage of children that need to be screened and have effectively had screening. These figure are not that meaningful in table 1

Figures 2 and 3 have informative data but perhaps it would even be more clear if you could indicate the desired days and thus demonstrate the delay.

Very wordy somethimes the Enlish reads like sSpannish: vcan benefit from native spreaking to clean up the manuscript and use more efficient wordings

Author Response

thank you very much for your comments it has been very useful for a better text. find attached a poin by point answer to your queries. best regards

Author Response File: Author Response.docx

Reviewer 2 Report

 

General comments:

This manuscript is related to the topic of the newborn screening and rescreening. This is very important topic, especially rescreening as it is rarely covered in the literature. The manuscript is written in an interesting way and is easy to follow. The figures present the results very well. There  are only 21 references and they consist of many national papers which are not in English. I suggest to provide some more references, especially to international studies. The authors often use the term otoemission, I suggest to use broadly used term otoacoustic emission. Also often the authors use dB without providing which type it is. It should be always stated if there are dB SPL or dB HL.

 

Specific comments:

L14 otoemission – please use otoacoustic emissions

L30-32 – CODEPH – please provide some more information for the reader along with references.

L99 automatic brain response – I guess it should be automatic auditory brainstem response

L 114 – dB SPL?

L121 – dB HL?

L225 otoemission – please use otoacoustic emissions

L245-247 please provide citation

L267-275 – the authors should also mentioned that the problems with equipment may also be source of false positives. Unfortunately audiologists take the various systems and provided results for granted, while there are significant differences in performance of different systems, e.g.:

Jedrzejczak WW, Gos E, Pilka E, Skarzynski PH, Skarzynski H, Hatzopoulos S. Pitfalls in the Detection of Hearing Loss via Otoacoustic Emissions. Applied Sciences. 2021; 11(5):2184. https://doi.org/10.3390/app11052184

L319 – please cite some international studies with comparable results.

L420 – dB HL?

L426 – dB HL?

 

I suggest to provide some more references, especially to international studies, e.g.:

Holzinger D, Weishaupt A, Fellinger P, Beitel C, Fellinger J. Prevalence of 2.2 per mille of significant hearing loss at school age suggests rescreening after NHS. Int J Pediatr Otorhinolaryngol. 2016 Aug;87:121-5. doi: 10.1016/j.ijporl.2016.06.006.

Zeng QX, Luo RZ, Yan SB, Tang YQ, Wen RJ, Liu WL. Screening strategy and time points for newborn hearing re-screening with high risk factors. World J Otorhinolaryngol Head Neck Surg. 2022 Apr 18;8(3):257-261. doi: 10.1016/j.wjorl.2020.09.002.

Author Response

thank you very much for your comments it has been very useful for a better text. find attached a poin by point answer to your queries. best regards

Author Response File: Author Response.docx