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. 2023 May 18;13(5):e070259.
doi: 10.1136/bmjopen-2022-070259.

Effectiveness and costs of a low-threshold hearing screening programme (HörGeist) for individuals with intellectual disabilities: protocol for a screening study

Katharina Schwarze  1 , Philipp Mathmann  2 , Karolin Schäfer  3 , Werner Brannath  4 , Phillip-Hendrik Höhne  5 , Sibel Altin  5 , Lukas Prein  2 , Awa Naghipour  2 , Susanna Marie Zielonkowski  2 , Susanne Wasmuth  2 , Oliver Kanaan  2 , Antoinette Am Zehnhoff-Dinnesen  2 , Anna Sophia Schwalen  2 , Anna Schotenröhr  2 , Martin Scharpenberg  4 , Sarah Schlierenkamp  6 , Nicole Stuhrmann  7   8 , Ruth Lang-Roth  9 , Muhittin Demir  10 , Sandra Diekmann  6 , Anja Neumann  11 , Corinna Gietmann  2 , Katrin Neumann  2
Affiliations

Effectiveness and costs of a low-threshold hearing screening programme (HörGeist) for individuals with intellectual disabilities: protocol for a screening study

Katharina Schwarze et al. BMJ Open. .

Abstract

Introduction: Individuals with intellectual disabilities (ID) often suffer from hearing loss, in most cases undiagnosed or inappropriately treated. The implementation of a programme of systematic hearing screening, diagnostics, therapy initiation or allocation and long-term monitoring within the living environments of individuals with ID (nurseries, schools, workshops, homes), therefore, seems beneficial.

Methods and analysis: The study aims to assess the effectiveness and costs of a low-threshold screening programme for individuals with ID. Within this programme 1050 individuals with ID of all ages will undergo hearing screening and an immediate reference diagnosis in their living environment (outreach cohort). The recruitment of participants in the outreach group will take place within 158 institutions, for example, schools, kindergartens and places of living or work. If an individual fails the screening assessment, subsequent full audiometric diagnostics will follow and, if hearing loss is confirmed, initiation of therapy or referral to and monitoring of such therapy. A control cohort of 141 participants will receive an invitation from their health insurance provider via their family for the same procedure but within a clinic (clinical cohort). A second screening measurement will be performed with both cohorts 1 year later and the previous therapy outcome will be checked. It is hypothesised that this programme leads to a relevant reduction in the number of untreated or inadequately treated cases of hearing loss and strengthens the communication skills of the newly or better-treated individuals. Secondary outcomes include the age-dependent prevalence of hearing loss in individuals with ID, the costs associated with this programme, cost of illness before-and-after enrolment and modelling of the programme's cost-effectiveness compared with regular care.

Ethics and dissemination: The study has been approved by the Institutional Ethics Review Board of the Medical Association of Westphalia-Lippe and the University of Münster (No. 2020-843 f-S). Participants or guardians will provide written informed consent. Findings will be disseminated through presentations, peer-reviewed journals and conferences.

Trial registration number: DRKS00024804.

Keywords: adult otolaryngology; audiology; developmental neurology & neurodisability; health economics; paediatric otolaryngology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of the three-step HörGeist screening programme. 1Screening staff; 2Physician; 3Hearing aid acoustician; *In case of failed screening, reference PTA is the diagnostic PTA. ABR, auditory brainstem response; PTA, pure tone audiometry.
Figure 2
Figure 2
Study protocol and outcome assessment.
See this image and copyright information in PMC

References

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