Comparison of the CAPAS and Ewing tests for screening of hearing in infants

Abstract

Objective: To study the similarities and differences between the non-automated labour intensive Ewing hearing test and the less labour intensive automated CAPAS (Compact Amsterdam Paedo-Audiometrical Screening) hearing test.

Setting: A multicentre study in which all the children born in the eastern part of the Netherlands between 1 January 1996 and 1 April 1997 were routinely screened for hearing impairment at 9 months of age.

Methods: Differences and similarities between the two methods were described for the proportion of children who failed every test, the percentage of referred children, the yield of bilateral and unilateral otitis media with effusion (OME), the positive predictive value of the third test result, and the yield of persistent OME after 4-6 months' follow up at an ENT department.

Results: 12,603 infants were screened with the CAPAS test and 17,496 with the Ewing test. There were differences between the CAPAS and Ewing tests respectively in the proportions of children lost to follow up (10.1% v 15.2%), the proportions of children referred diagnosed with OME (59% v 81%), the yield of bilateral otitis media with effusion (2.4% v 3.0%), and the yield of persistent OME after 4-6 months' follow up (1.1% v 1.6%).

Conclusions: The CAPAS test is more practical than the Ewing test, but the non-automated Ewing test seems to be more reliable and valid for detecting conductive hearing loss.