title: Follow-up in newborn hearing screening - A systematic review.
abstract: BACKGROUND
  The quality and efficiency of newborn hearing screening programs (NHS) rely heavily on appropriate follow-up. The Joint Committee on Infant Hearing recommends a follow-up rate of more than 95% of infants who fail the initial hearing screening. However, a 70% benchmark is considered to be more feasible. This high loss to follow-up (LTF) rate acts as a threat to the overall success of NHS programs. The objective of the study was to identify and examine the reported rates of LTF, attributed reasons for LTF and strategies undertaken to reduce LTF.
  
  
  METHODS
  Using a systematic search, articles published between 2005 to December 2015 were identified from PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Educational Resources Information Center (ERIC), Scopus, Ovid, ProQuest, and Cochrane Library. To be included in the review, the study should be exploring the loss to follow-up or drop-out rate in newborn hearing screening programs and be published in an indexed peer-reviewed journal in the English language. The main outcome measures were overall rate of LTF, factors leading to LTF and measures adopted to overcome LTF.
  
  
  RESULTS
  53 articles were short-listed for data extraction. Out of these, 27 were single-centre studies, 19 were multi-centre, 3 compared multiple databases, and 4 used survey-based methods. Overall LTF rates of 20% in single-centre and 21% in multiple-centre studies were observed. Educational disparity and lack of adequate knowledge among parents were associated with LTF. The most commonly used strategy to overcome LTF suggested by studies was the use of an adequate data management system.
  
  
  CONCLUSIONS
  This review is a novel attempt to explore the LTF among NHS studies, reasons for LTF and strategies to reduce LTF. This review can act as a basis for planning and execution of effective NHS programs.
authors.affiliation: Dept. of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India. Electronic address: rohitravi94@gmail.com.
authors.forename: Rohit
authors.initials: R
authors.lastname: Ravi
authors.affiliation: Dept. of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India.
authors.forename: Dhanshree R
authors.initials: DR
authors.lastname: Gunjawate
authors.affiliation: Dept. of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India.
authors.forename: Krishna
authors.initials: K
authors.lastname: Yerraguntla
authors.affiliation: Neonatal Intensive Care Unit, Department of Pediatrics, Kasturba Medical College, Manipal, Karnataka, India.
authors.forename: Leslie E
authors.initials: LE
authors.lastname: Lewis
authors.affiliation: University of Queensland, Hearing Research Unit for Children, St Lucia, QLD, Australia.
authors.forename: Carlie
authors.initials: C
authors.lastname: Driscoll
authors.affiliation: Dept. of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India.
authors.forename: Bellur
authors.initials: B
authors.lastname: Rajashekhar
mesh_terms: D000359:Aftercare; D016208:Databases, Factual; D004522:Educational Status; D007722:Health Knowledge, Attitudes, Practice; D034381:Hearing Loss / Q000151:congenital / Q000175:diagnosis*; D006320:Hearing Tests; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D059012:Lost to Follow-Up; D015997:Neonatal Screening; D010290:Parents; D015397:Program Evaluation
keywords: Follow-up; Loss to follow-up; Newborn hearing screening; Reasons; Strategies