Syst Rev. 2025 Dec 3. doi: 10.1186/s13643-025-03003-x. Online ahead of print.
ABSTRACT
BACKGROUND: Auditory Steady-State Response (ASSR) allows the identification of infants with hearing loss and consequently early intervention. Therefore, it is important to assess the accuracy of ASSR for determining hearing thresholds in infants. This study aimed to systematically review the threshold differences between air-conducted ASSR and behavioural audiometry (BA) in infants.
METHODS: The population was infants younger than 2 years; the intervention was ASSR thresholds; the comparator was BA thresholds; and the outcome was the ASSR-BA threshold, i.e., the correction value in dB. PubMed, Web of Science, The Cochrane Central Register of Controlled Trials, and Embase were searched. The risk of bias was evaluated using the Evidence Project risk of bias tool and the Newcastle-Ottawa Quality Assessment Scale. The mean and 95% confidence intervals (CI) were calculated for the threshold differences at four frequencies (0.5, 1, 2, and 4 kHz).
RESULTS: Of 503 articles identified, 10 were eligible for a narrative summary, and seven were included in the meta-analysis, which had a total of 2845 ASSR-BA thresholds. The articles were of moderate quality and showed substantial heterogeneity (I2 between 89 and 96%, p < 0.01). The mean differences (± 95% CI) between ASSR thresholds and BA hearing thresholds were 9.24 dB (± 6.45), 7.19 dB (± 4.02), 6.35 dB (± 4.51), and 7.42 dB (± 5.40) at 0.5, 1, 2, and 4 kHz, respectively.
CONCLUSIONS: ASSR provides a reasonably accurate prediction of BA thresholds. Given the heterogeneity of the included studies, further research with larger infant populations is needed.
SYSTEMATIC REVIEW REGISTRATION: The study was pre-registered in PROSPERO and followed PRISMA-P 2015 statement.
PMID:41339881 | DOI:10.1186/s13643-025-03003-x
