Next steps in developing a national newborn hearing screening data set

1a. Establishment of an advisory committee to:

• Advise the AIHW on the scope of and development of data items for inclusion in a national collection.
• Advise the AIHW on newborn hearing screening data collection processes within their state/territory’s jurisdiction.
• Advise on the costs and timing of implementing proposed new data items for national reporting, including the capacity and preparedness of the jurisdictions and other relevant bodies/agencies to collect and provide these data.
• Advise on the revision of national performance indicators.
• Advise on the content and structure of draft AIHW reports relating to newborn hearing screening data.
• Promote the use of national standards in relevant local and national data collections.

The National Neonatal Hearing Screening Data Development Committee, chaired by the AIHW, was established in October 2023.

All state and territory departments responsible for newborn hearing screening are represented on the data development committee to ensure national agreement and consistency.

The committee met formally three times and collaborated on 2 out-of-session consultation papers.

1b. Agreement on the scope of the data collection: In consultation with the advisory committee, AIHW will define and gain agreement on what the NBEDS will include and exclude.

• Identification of data items for development: through consultation and collaboration with the advisory committee, AIHW will gain agreement on data items to be included in the NBEDS.
• Draft standards for data items: consultation and collaboration through the advisory committee to draft standards for data items to be included in the NBEDS.

The scope of the data collection, with inclusion and exclusion criteria has been agreed by the data development committee.

21 data items have been agreed for inclusion in the initial NBEDS by the data development committee.

Data standards have been developed to accompany the data items.

The data development committee reached agreement on definitions of data items in August 2024.

Specifics on collection methods are yet to be discussed, pending the next phase of development of the data collection.

Development of the NBEDS has sought to align with the proposed reporting under the National Framework for Newborn Hearing Screening.

This report outlines feasibility of reporting against the newborn hearing screening indicators (1–4).

Further development and feasibility assessment are required for indicators related to audiology, amplification and implantation services and early intervention.

NSW

Statewide Infant Screening - Hearing (SWISH) Program:

• Well baby (medically stable) over 34 weeks gestation.
• Four hours old to one month (corrected age).

Note: The NSW Health SWISH Program aims to complete newborn hearing screening to eligible babies by one month of age, identify babies born with congenital permanent childhood hearing impairment by 3 months of age and facilitate access to appropriate amplification and early intervention by 6 months of age. Screening can be completed up to 6 months of age.

Stillborn.

Neonatal death prior to newborn hearing screening.

Note that the NSW Policy Directive is still being reviewed and there may be additional exclusion criteria.

Screening should not be performed on babies less than gestational age of 34 weeks.

Babies with confirmed bacterial meningitis.

Babies with microtia or atresia.

Babies who remain medically unfit to screen at 3 months of age (corrected age).

Vic

Babies greater than 34 weeks and less than 6 months.

At least 4–6 hours old.

After treatments (vents, ototoxic meds) have ceased and ready for discharge.

Babies with known neurological conditions or compromised skin– discussed on case-by-case basis to decide direct refer or screen and refer.

Non live births.

Babies with Microtia/atresia are directly referred.

Babies with a pacemaker or programable implant need to be directly referred.

Qld

Live births, older than 34 weeks gestational age (ideally <1 month corrected age), are eligible to participate in the Healthy Hearing screening program.

Include deceased as eligible.

–

Note that hearing screening is not performed on the following and these bypass screening with direct refer to audiology:

• Medically unwell
• Microtia / atresia.

WA*

Greater than 34 weeks gestational age and less than six months.

Above 1500 grams.

After treatments (vents, ototoxic meds) have ceased and ready for discharge.

Medically stable.

Asleep or in a quiet settled state.

Have normal outer-ear anatomy in at least one ear and no major craniofacial anomalies that could impact on the screen (babies with microtia or atresia are included in newborn hearing screening).

It is medically inadvisable to attach the sensors and/or ear couplers, such as to compromised skin.

Major craniofacial anomaly exists.

Other conditions exist, which are deemed unsuitable for screening by medical staff and require a full diagnostic assessment by Audiology.

Occasional cases when the baby is receiving palliative care and the family and medical team have advised against screening.

SA

Includes babies >34 weeks gestation.

Babies <34 weeks.

Babies with microtia or atresia.

TAS

• Babies at >32 weeks’ gestation.
• Babies at least 4 hours old.

Babies <32 weeks.

Babies with microtia or atresia.

ACT

Babies >34 weeks gestation.

–

Babies deemed medically unfit (usually due to a neurological issue or severe skin condition).

NT

Babies ≥35 weeks’ gestation. Screening may be delayed post 35 weeks for any number of medical reasons, but we would aim to screen all babies who meet that milestone.

Occasional cases where babies are not screened because it is clear the baby is only receiving short term palliative care – often these babies have neurological conditions, sometimes not.

Babies with severe neurological conditions.

Babies with ear canal atresia or pinna.

State or territory identifier (baby)

Person – person identifier, XXXXXX[X(14)]

Demographic

Identifier for each baby that is unique within a state/territory screening program.

Allows for checking that records are unique and enables the AIHW to query records back to the state/territory.

Where possible, having the same identifier as provided to the National Perinatal Data Collection would allow for future linkage (noting the correct ethics and consent requirements would need to be fulfilled prior to linkage being undertaken).

Retained for inclusion in the NBEDS.

State or territory of birth (baby)

Birth event – state/territory of birth, code N (aihw.gov.au)

Demographic

Provides demographic information.

Retained for inclusion in the NBEDS.

Sex (baby)

Person – sex, code X (aihw.gov.au)

Demographic

Provides demographic information.

Retained for inclusion in the NBEDS.

Date of birth (baby)

Person – date of birth, DDMMYYYY (aihw.gov.au)

Demographic

Allows for calculation of chronological age.

Retained for inclusion in the NBEDS.

Gestational age (baby)

Product of conception – gestational age, total completed weeks N[N] (aihw.gov.au)

Demographic

Allows for the calculation of corrected age (that is, a premature baby's chronological age minus the number of weeks or months early they were born).

Retained for inclusion in the NBEDS.

Indigenous status (baby)

Person – Indigenous status, code N (aihw.gov.au)

Demographic

This item, when used in conjunction with the mother’s Indigenous status, is a baseline measure of health for Indigenous children.

Retained for inclusion in the NBEDS.

Indigenous status (mother)

Demographic

Indigenous status of mothers is a key data resource for assessing antenatal care in pregnancy and other interventions before or during pregnancy, aimed at improving the health of mothers and babies.

Removed: this item is not commonly collected as part of newborn hearing screening data. Capture of baby’s Indigenous status was considered to have primary importance for this collection.

Statistical Area Level 2 (SA2) of usual residence (mother)

Person – area of usual residence, statistical area level 2 (SA2) code (ASGS Edition 3) N(9) (aihw.gov.au)

Demographic

Used for geographical analysis (for example remoteness, socioeconomic status).

SA2 is the preferred data element to be used for geographical analysis (postcode should only be used when SA2 is not available). SA2 can be geocoded within state/territory health departments using the client’s address.

Retained for inclusion in the NBEDS.

Postcode of usual residence (mother)

Address – Australian postcode, code (Postcode datafile) NNNN (aihw.gov.au)

Demographic

May be used for geographical analysis (for example remoteness, socioeconomic status), however SA2 is preferred.

Retained for inclusion in the NBEDS.

State or territory of screen

Australian state/territory code N

Hearing screening

State/territory where screen was performed as this may occasionally differ from state/territory of birth.

Retained and developed during the current project phase.

Date of screen (date of screen 1, screen 2 & screen 3)

Hearing screening

Allows for calculation of age at screening.

Collecting data on the date and outcome for all screens performed (where an infant undergoes more than 1 screen) could be beneficial in providing data on the number of screens performed, informing resourcing and any variation in screening outcomes over multiple screens.

Revised; further developed during the current project phase. Revisions included:

• three separate items were included for the first three completed screens.
• ‘completed screen’ was defined.
• DDMMYYYY format was agreed.

Screen outcome

(Screen outcome 1, Screen outcome 2 & Screen outcome 3)

Hearing screening

Collecting data on the date and outcome for all screens performed (where an infant undergoes more than 1 screen) could be beneficial in providing data on the number of screens performed, informing resourcing and any variation in screening outcomes over multiple screens.

Revised; further developed during the current project phase. Revisions included:

• three separate items were included for the first three completed screens.
• ‘completed screen’ was defined.
• revised from being a dichotomous data element indicating whether an infant tested positive (refer) or negative (pass) to include pass, unilateral refer, bilateral refer, not screened and not stated.

Overall outcome of screening

Hearing screening

Provides a determination of the overall outcome of the screening process according to the following categories:

1. Complete, discharged from screening

2. Complete, referred for targeted follow-up

3. Complete, referred for audiological assessment

4. Bypass, non-screening pathway

5. Screening in process

6. Incomplete

9. Not stated/inadequately described

Enables the calculation of the proportion of eligible babies that have completed screening by 30 days of age (corrected).

New item added in the current project phase.

Date of hearing screening completion

Hearing screening

Screening completion date enables the calculation of the proportion of eligible babies that have completed screening by 30 days of age (corrected).

New item added in the current project phase.

Agreed to be collected in DDMMYYYY format.

Reason not screened

Hearing screening

Provides an overview of why some babies are unable to be screened:

1. Declined

2. Missed screening

3. Moved interstate

4. Medical exclusion

5. Hearing screen bypass

6. Baby deceased

7. Ineligible

8. Other

9. Not stated/ inadequately described

Revised and further developed during the current project phase. Revisions included:

• categorisation of reasons into 8 discrete categories that reflected current practice.
• noted the item should pertain to the primary/main reason not screened.

Referral outcome

Hearing screening

This item captures the referral from the jurisdictional newborn hearing screening program within the following categories:

1. Referral following positive screen

2. Referral following negative screen

3. Referral without screening

4. No referral required

5. No referral provided

9. Not stated/inadequately described

New item added in the current project phase.

Will aid in the calculation of the National Framework indicator: Proportion of babies that require referral to audiological assessment are referred within 3 business days of screening.

Date of referral

Hearing screening

This item captures the date in which the newborn has been referred from the jurisdictional hearing screening program.

New item added in the current project phase.

Will aid in the calculation of the National Framework indicator: Proportion of babies that require referral to audiological assessment are referred within 3 business days of screening.

Referral type

Hearing screening

This item captures the type of service the referral was made (from the jurisdictional hearing screening program) within the following categories:

1. Audiologist: audiological assessment

2. Audiologist: targeted follow-up

7. Other

9. Not stated/inadequately described

New item added in the current project phase.

Will provide context to the National Framework indicator: Proportion of babies that require referral to audiological assessment are referred within 3 business days of screening.

Name (baby)

May be considered for future development to enable linkage with other data collections.

The collection of this data item is currently inconsistent nationally. Newborns are often considered a difficult cohort to collect this type of information for as they are often screened and discharged from hospital prior to their name being recorded (often being recorded instead as “baby of <mother’s name>” in most screening databases).

Use of client identifiers such as the Statistical Linkage Key ‘SLK-581’ which includes 3 letters of family name, 2 letters of given name, date of birth and sex) may be considered if robust client demographics can be collected.

Not included, requires further development.

Name (mother)

May be considered for future development to enable linkage with other data collections.

Not included, requires further development.

Address (mother/baby)

May be considered for future development to enable linkage with other data collections.

Not included, requires further development.

Medicare number (mother/baby)

May be considered for future development to enable linkage with other data collections.

This data item is predominantly unavailable in state and territory screening databases.

Not included, requires further development.

Culturally and linguistically diverse (CALD) identifier (mother)

The collection of CALD data across jurisdiction’s screening databases is limited, with information collected usually around the mother’s primary spoken language and/or whether an interpreter is required. These are not currently considered to be a good indicator of a person’s CALD background.

More beneficial data would likely be sourced using linked data in future (for example country of birth data from the Census), which is often used to supplement information in data sets that do not collect this information.

Not included, requires further development.

Risk factors

May be considered for future development.

Risk factors can include a family history of hearing impairment, exposure to congenital infections or ototoxic medications, and syndromes associated with hearing loss, such as Down syndrome. Data items on the prevalence and monitoring of infants with these risk factors and their outcomes should also be considered for inclusion in a national data collection to enable research into risk factors and health outcomes associated with permanent congenital hearing impairment.

Not included, requires further development.

Early intervention

Could include:

• Date of first attendance at early intervention
• Active/approved NDIS client status

May be considered for future development.

Data on engagement with early intervention services is poorly collected nationally, with 7 of 8 jurisdictions reporting no, or extremely limited, data. Most jurisdictions advised that these data are not usually provided back to the state and territory programs by the early intervention service providers. Further data development work would need to be undertaken to establish the most appropriate source(s) of these data (for example, sourcing data directly from the early intervention services may need to be considered).

Data sources may include NDIS.

Not included, requires further development.

Amplification services data

• Assistive hearing device flag
• Date first hearing device fitted
• First assistive hearing device type

Data could potentially be sourced from Hearing Australia.

Not included, requires further development.

Implantation services

• Implantable hearing device flag
• Date first implantable hearing device fitted
• First implantable assistive hearing device type

Cochlear implants, bone conduction implants (surgical and non-surgical) and middle ear implants are some examples of implantable hearing devices.

Hearing Australia do provide bone conduction devices to eligible people and may hold relevant data.

Hearing Australia do not perform cochlear implant evaluation or surgery but do provide support and have a close relationship with cochlear implant clinics. The relevant data holdings for cochlear implants would require further exploration.

Not included, requires further development.

1. Person identifier (baby)

Demographic

Definition: Identifier for each baby that is unique within a state/territory screening program.

Permissible values: 2–20 characters long. This can be a combination of alphanumeric characters and dashes (-).

METEOR identifier: 290046

Guide for use:

• Individual agencies, establishments or collection authorities may use their own alphabetic, numeric or alphanumeric coding systems.
• Field cannot be blank.
• Identifier for each baby that is unique within a state/territory screening program.
• Each ID is used by only one baby and each baby has only one ID.

2. State or territory of birth (baby)

Demographic

Definition: The state or territory in which a baby was delivered, as represented by a code.

Permissible values:

1. New South Wales

2. Victoria

3. Queensland

4, South Australia

5. Western Australia

6. Tasmania

7. Northern Territory

8. Australian Capital Territory

9. Other

99. Not stated/inadequately described

METEOR identifier: 718242

Guide for use:

• The order presented here is the standard for the Australian Bureau of Statistics (ABS). Other organisations (including the Australian Institute of Health and Welfare) publish data in state order based on population (that is, Western Australia before South Australia and Australian Capital Territory before Northern Territory).
• Only date of birth for the baby is collected.
• In this collection ‘other territories’ is replaced with ‘other’.
• ‘Other’ refers to babies who are born outside of the state or territory of their current newborn hearing screening, but the specific jurisdiction of birth is unknown.
• Where a baby was born outside Australia, this may also be captured in the ‘Other’ category.

3. Date of birth (baby)

Demographic

Definition: The date of birth of the person, expressed as DDMMYYYY.

Permissible values: DDMMYYYY

METEOR identifier: 287007

Guide for use:

• If date of birth is not known or cannot be obtained, provision should be made to collect or estimate age. Collected or estimated age would usually be in years for adults, and to the nearest three months (or less) for children aged less than two years. Additionally, an estimated date flag or a date accuracy indicator should be reported in conjunction with all estimated dates of birth.
• For data collections concerned with children's services, it is suggested that the estimated date of birth of children aged under 2 years should be reported to the nearest 3-month period, that is, 0101, 0104, 0107, 0110 of the estimated year of birth. For example, a child who is thought to be aged 18 months in October of one year would have his/her estimated date of birth reported as 0104 of the previous year. Again, an estimated date flag or date accuracy indicator should be reported in conjunction with all estimated dates of birth.
• Only date of birth for the baby is collected.
• Allows for the calculation of chronological age.
• No estimated date flag is included as this is considered a robust item within newborn hearing screening.

If the date is not unknown and cannot be estimated, it can be recorded as 99999999.

4. Gestational age at birth (baby)

Demographic

Definition: The gestational age of a baby in completed weeks.

Permissible values:

• Total completed weeks
• Supplementary value: 99 Not stated/unknown.

METEOR identifier: 695332

Guide for use:

• Gestational age is the best clinical estimate of the duration of pregnancy at a specific point in time, based on the first day of the last menstrual period (LMP), ultrasound or physical examination of the baby.
• Gestational age is conventionally expressed in completed weeks. When gestational age is calculated using the first day of the LMP, the first day is counted as day zero and not day one. Therefore, a 25 week, 5 day fetus is considered a 25 week fetus (25+0, 25+1, 25+2, 25+3, 25+4, 25+5, 25+6).
• When ultrasound is used to date a pregnancy, the earliest ultrasound examination should be used and should preferably be between 6 and 10 weeks gestation. Scans performed beyond 24 weeks gestation are unlikely to be reliable in estimating gestational age and should not be used for this purpose.
• The World Health Organization identifies the following categories for duration of gestation:
  • pre-term: less than 37 completed weeks (less than 259 days) of gestation
  • term: from 37 completed weeks to less than 42 completed weeks (259 to 293 days) of gestation
  • post-term: 42 completed weeks or more (294 days or more) of gestation
• Gestational age allows for the calculation of corrected age (that is, a premature baby’s chronological age minus the number of weeks or months early they were born).
• Gestational age relates to the baby.

5. Sex (baby)

Demographic

Definition: The sex of a person, as represented by a code.

Permissible values:

1. Male

2. Female

3. Another term

9. Not stated/inadequately described

METEOR identifier: 741686

Guide for use:

• This Value Domain is based on the Australian Bureau of Statistics Standard for sex, gender, variations of sex characteristics and sexual orientation variables (ABS 2021). The values are defined as follows:

CODE 1 – Male

Persons whose sex at birth or infancy was recorded as male, or who reported their sex as male at the time of collection.

CODE 2 – Female

Persons whose sex at birth or infancy was recorded as female, or who reported their sex as female at the time of collection.

CODE 3 – Another term

Persons whose sex at birth or infancy was recorded as another term (not male or female), or who reported their sex as another term (not male or female) at the time of collection.

The value meaning of "Another term" has been assigned to Code 3 for this value domain, which replaces "Other" and "Intersex or indeterminate" in previous versions of this element. The third option recognises that across Australian jurisdictions and elsewhere there are a range of terms used.

CODE 9 – Not stated/inadequately described

This supplementary value is used to code inadequately described responses and non-responses for sex. It is not to be used on primary collection forms. It is primarily for use in administrative collections when transferring data from data sets where the item has not been collected.

• A person's sex is based upon their sex characteristics, such as their chromosomes, hormones and reproductive organs. While typically based upon the sex characteristics observed and recorded at birth or in infancy, a person's reported sex can change over the course of their lifetime and may differ from their sex recorded at birth.
• Sex is only collected for the baby.

6. Indigenous status (baby)

Demographic

Definition: Whether a person identifies as being of Aboriginal or Torres Strait Islander origin, as represented by a code.

Permissible values:

1. Aboriginal but not Torres Strait Islander Origin

2. Torres Strait Islander but not Aboriginal origin

3. Both Aboriginal and Torres Strait Islander origin

4. Neither Aboriginal nor Torres Strait Islander origin

Supplementary values:

9. Not stated/inadequately described

METEOR identifier: 602543

Guide for use:

• This metadata item is based on the Australian Bureau of Statistics (ABS) standard for Indigenous status (ABS 2014).
• The classification for Indigenous status has a hierarchical structure comprising two levels. There are four categories at the detailed level of the classification which are grouped into two categories at the broad level. There is one supplementary category for 'Not stated/inadequately described' responses. The classification is as follows:
• Indigenous Australians:
  • Aboriginal but not Torres Strait Islander origin.
  • Torres Strait Islander but not Aboriginal origin.
  • Both Aboriginal and Torres Strait Islander origin.
• Non-Indigenous Australians:
  • Neither Aboriginal nor Torres Strait Islander origin.
• Not stated/inadequately described: This category is not to be available as a valid answer to the questions but is intended for use:
  • Primarily when importing data from other data collections that do not contain mappable data.
  • Where the answer cannot be determined without clarification from the respondent (for example, 'No' and 'Yes, Aboriginal' are both selected).
  • Where an answer was declined.
  • Where the question was not able to be asked because the client was unable to communicate or a person who knows the client was not available.
• This item refers to the Indigenous status of the baby – whether either the mother or the father, or both parents, identified as being of Aboriginal or Torres Strait Islander origin, as represented by a code.
• For Indigenous status of the baby, it is recommended that parents are asked if the baby’s mother or father are of Aboriginal or Torres Strait Islander origin, (or both).
• Indigenous status of the mother is not collected.

7. Statistical Area Level 2 (SA2) of usual residence (mother)

Demographic

Definition: The geographical region in which a person or group of people usually reside, as represented by a statistical area level 2 (SA2) code.

Permissible values: Components of SA2: State, SA4, SA3, SA2.

METEOR identifier: 747315

Guide for use:

• An SA2 is identifiable by a 9-digit fully hierarchical code. The SA2 identifier is a 4-digit code, assigned in alphabetical order within a Statistical area level 3 (SA3). An SA2 code is only unique within a state/territory if it is preceded by the state/territory identifier.
• The SA2 should be collected based on the usual residence of the mother of the baby.
• This item is used for geographical analyses (for example remoteness, socioeconomic status).
• SA2 is the preferred data element to be used for geographical analysis (postcode should only be used when SA2 is not available). SA2 can be geocoded within state/territory health departments using the client’s address.

8. Postcode of usual residence (mother)

Demographic

Definition: The Australian numeric descriptor for a postal delivery area for an address.

Permissible values:

• A full list of Australian postcodes can be found at Australia Post
• Supplementary values:
  • 0097 Not applicable
  • 0098 Unknown
  • 0099 Not stated/ inadequately described
  • Code 0097 Not applicable: This code should be used in circumstances where it is not applicable to record an Australian postcode, for example, when there is no fixed address, or when an international (non-Australian) postcode is supplied.
• This item refers to the postcode of the usual residence of the mother of the baby.
• This data element may be used in the analysis of data on a geographical basis (for example remoteness, socioeconomic status) which involves coding data containing an address with a postcode to the Australian Bureau of Statistics (ABS) Australian Statistical Geography Standard (ASGS) areas.
• A more accurate way to convert address data to ASGS geography is to use the locality to SA2 coding index, available from ABS, where the locality, postcode and state, (which are all part of an address), used in conjunction can effectively code data to the SA2 level and above in the ASGS.
• While postcode may be used for geographical analysis, SA2 is preferred for this collection.

METEOR identifier: 611398

Guide for use:

• Code 0097 Not applicable: This code should be used in circumstances where it is not applicable to record an Australian postcode, for example, when there is no fixed address, or when an international (non-Australian) postcode is supplied.
• This item refers to the postcode of the usual residence of the mother of the baby.
• This data element may be used in the analysis of data on a geographical basis (for example remoteness, socioeconomic status) which involves coding data containing an address with a postcode to the Australian Bureau of Statistics (ABS) Australian Statistical Geography Standard (ASGS) areas.
• A more accurate way to convert address data to ASGS geography is to use the locality to SA2 coding index, available from ABS, where the locality, postcode and state, (which are all part of an address), used in conjunction can effectively code data to the SA2 level and above in the ASGS.
• While postcode may be used for geographical analysis, SA2 is preferred for this collection.

9. State or territory of screen

Hearing screening

Definition: State or territory where the current hearing screen was performed, as represented by a code.

Permissible values:

1. New South Wales

2. Victoria

3. Queensland

4.South Australia

5. Western Australia

6. Tasmania

7. Northern Territory

8. Australian Capital Territory

9. Not stated/inadequately described

METEOR identifier: 718228

Guide for use: State of screen relates to the baby.

• This item may differ from state or territory of birth.
• Does not include other territories.

10. Date of first completed screen

Hearing screening

Definition: The date in which the newborn has been screened for possible hearing loss for the first time, expressed as DDMMYYYY.

Permissible values: DDMMYYYY

METEOR identifier: 270566

Guide for use: Date of screen relates to the baby.

• No estimated date flag is included as this is considered a robust item within newborn hearing screening.
• If the date is not unknown and cannot be estimated, it can be recorded as 99999999.

11. Outcome of first completed screen

Hearing screening

Definition: Whether a baby tested positive (refer) either unilaterally or bilaterally or negative (pass) for possible hearing loss on the first screen, as represented by a code.

Permissible values:

1. Pass (negative)

2. Unilateral refer (positive)

3. Bilateral refer (positive)

4. Not Screened

9. Not stated/inadequately described

METEOR identifier: to be developed

Guide for use: Outcome of completed screens relate to the baby.

• The outcome of screen 1 can be used to determine the overall pass or refer status of the baby’s screen (if this is the baby’s first and final completed screen).
• In conjunction with other items (discharge date) allows for reporting on proportion of babies that have pass results on first screen who are discharged.

12. Date of second completed screen

Hearing screening

Definition: The date in which the newborn has been screened for possible hearing loss for a second time, expressed as DDMMYYYY.

Permissible values: DDMMYYYY

METEOR identifier: 270566

Guide for use:

• Date of screen relates to the baby.
• No estimated date flag is included as this is considered a robust item within newborn hearing screening.
• If the date is not unknown and cannot be estimated, it can be recorded as 99999999.

13. Outcome of second completed screen

Hearing screening

Definition: Whether a baby tested positive (refer) either unilaterally or bilaterally or negative (pass) for possible hearing loss on the second screen, as represented by a code.

Permissible values:

1. Pass (negative)

2. Unilateral refer (positive)

3. Bilateral refer (positive)

4. Not Screened

9. Not stated/inadequately described

METEOR identifier: to be developed

Guide for use:

• Outcome of completed screens relate to the baby.
• The outcome of screen 2 can be used to determine the overall pass or refer status of the baby’s screen (if it relates to the second and final completed screen).

14. Date of third completed screen

Hearing screening

Definition: The date in which the newborn has been screened for possible hearing loss for the third time, expressed as DDMMYYYY.

Permissible values: DDMMYYYY

METEOR identifier: 270566

Guide for use:

• Date of completed screens related to the baby.
• Three screens are not applicable in all jurisdictions.
• Date of screen relates to the baby.
• No estimated date flag is included as this is considered a robust item within newborn hearing screening.
• If the date is not unknown and cannot be estimated, it can be recorded as 99999999.

15. Outcome of third completed screen

Hearing screening

Definition: Whether a baby tested positive (refer) or negative (pass) for possible hearing loss on the third screen, as represented by a code.

Permissible values:

1. Pass (negative)

2. Unilateral refer (positive)

3. Bilateral refer (positive)

4. Not Screened

9. Not stated/inadequately described

METEOR identifier: to be developed.

Guide for use:

• Outcome of completed screens relate to the baby.
• The outcome of screen 3 can be used to determine the overall pass or refer status of the baby’s screen.
• Some jurisdictions perform a 3rd screen where babies obtain result reversals (flip flop) in the first 2 screens. However, third screens can also be performed for other reasons.

16. Overall outcome of screening

Hearing screening

Definition: The outcome of the newborn hearing screening process, as represented by a code.

Permissible values:

1. Complete, discharged from screening

2. Complete, referred for targeted follow-up

3. Complete, referred for audiological assessment

4. Bypass, non-screening pathway

5. Screening in process

6. Incomplete

9. Not stated/inadequately described

METEOR identifier: to be developed.

Guide for use:

• Screen outcome relates to the baby.
• Screen outcome enables the calculation of the proportion of eligible babies that have completed screening by 30 days of age (corrected).

17. Date of hearing screening completion

Hearing screening

Definition: The date in which the baby has completed hearing screening expressed as DDMMYYYY.

Permissible values: DDMMYYYY

METEOR identifier: 270566

Guide for use: Screening completion date relates to the baby.

• Screening completion date enables the calculation of the proportion of eligible babies that have completed screening by 30 days of age (corrected).
• Date of hearing screening completion relates to the baby.
• No estimated date flag is included as this is considered a robust item within newborn hearing screening.
• When an estimate is required, all known fields should be entered (for example if year and month are known use 01/MM/YYYY; if the exact date is unknown but the calendar year to which it relates can be determined, use 01/07/YYYY).
• If the date is not known and can’t be estimated, please record 99999999.

18. Primary reason not screened or completed

Hearing screening

Definition: The primary reason why a baby was not screened or where screening was incomplete, as represented by a code.

Permissible values:

1. Declined

2. Missed screening

3. Moved interstate

4. Medical exclusion

5. Hearing screen bypass

6. Baby deceased

7. Ineligible

8. Other

9. Not stated/ inadequately described

METEOR identifier: to be developed.

Guide for use: Reasons not screened relate to the baby.

19. Referral outcome

Hearing screening

Definition: The outcome of the referral from the jurisdictional hearing screening program, as represented by a code.

Permissible values:

1. Referral following positive screen

2. Referral following negative screen

3. Referral without screening

4. No referral required

5. No referral provided

9. Not stated/inadequately described

METEOR identifier: to be developed.

Guide for use: Referral outcome relates to the baby.

20. Date of referral

Hearing screening

Definition: The date in which the newborn has been referred from the jurisdictional hearing screening program, expressed as DDMMYYYY.

Permissible values: DDMMYYYY

METEOR identifier: 270566

Guide for use:

• Referral date of screen relates to the baby.
• No estimated date flag is included as this is considered a robust item within newborn hearing screening.
• When an estimate is required, all known fields should be entered (for example, if year and month are known use 01/MM/YYYY; if the exact date is unknown but the calendar year to which it relates can be determined, use 01/07/YYYY).
• If the date is not unknown and cannot be estimated, it can be recorded as 99999999.

21. Referral type

Hearing screening

Definition: The type of service the referral was made (from the jurisdictional hearing screening program).

Permissible values:

1. Audiologist: audiological assessment

2. Audiologist: targeted follow-up

7. Other

9. Not stated/inadequately described

METEOR identifier: to be developed.

Guide for use:

• Referral type relates to the baby.