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Arch Pediatr Adolesc Med. 2001;155:421-422.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Kemper and Downs¹ presented a cost-effectiveness analysis of 2 methods of identification of permanent congenital hearing loss (PCHL) but chose not to consider the benefits of universal newborn hearing screening (UNHS), leaving their article no more than a cost comparison. This lapse remains a fatal flaw.

Permanent congenital hearing loss is arguably the most common serious congenital anomaly. Strategies other than UNHS fail to identify sufficient proportions of affected children in a timely manner. Targeted high-risk screening can at best identify 59% of children with PCHL.¹ Most studies report that fewer than 50% of children with hearing loss have identifiable risk factors.^{2, 3, 4, 5, 6, 7} In practice, targeted screening programs have done even more poorly,⁸ which has been our experience in Oregon.

The average age of identification of PCHL prior to universal screening programs is 2.5 years, which underscores the limited ability of parents and health care providers to identify the condition by . . . [Full Text of this Article]