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Table 1 Quality indicators and related benchmarks assessed in our study

From: Evaluating reporting and process quality of publications on UNHS: a systematic review of programmes

ID Indicator Benchmark Source Numerator Denominator Dimension
1 Recruitment ≥95 % AAPa, 1999 and JCIH, 2007 Number of neonates that have a hearing screening test by 1 month of age Number of neonates Universality
Percentage of newborns who complete screening by 1 month of age
2 Adherence ≥70 % AAP, 1999, JCIH, 2000 Number of neonates positive at the first screening test minus neonates who do not complete further testing (lost to follow-up) Number of neonates positive at the first screening test Universality
Follow-up rate
3 Timely definitive audiological evaluation ≥90 % JCIH, 2007 Number of neonates undergoing definitive audiological evaluation by 3 months of age Number of neonates undergoing a definitive audiological evaluation due to failed screening tests Timely detection
Percentage of newborns who complete audiological evaluation by 3 months of age
4a High-risk measured prevalence 2 % - 5 % (available prevalence rates [5]) Data from Scientific literature Number of screened neonates with audiological risk factors identified with hearing loss after definitive audiological evaluation Number of screened neonates with audiological risk factors (at net of the lost to follow-up) Timely detection
Observed prevalence in high-risk population
4b Low-risk measured prevalence Not available (N.A.) N.A. Number of screened neonates without any audiological risk factor identified with hearing loss after definitive audiological evaluation Number of screened neonates without any audiological risk factors (at net of all the lost to follow-up) Timely detection
Observed prevalence in low-risk population
4c Overall measured prevalence 0.1 % - 0.3 % (available prevalence rates [14]) Data from scientific literature Number of screened neonates (with and without audiological risk factors) identified with hearing loss after definitive audiological evaluation Number of screened neonates with or without audiological risk factors (at net of the lost to follow-up) Timely detection
Observed prevalence for whole population
5 Referral rate at discharge a) 5-20 % (for only otoemissions) Adapted from AAP, 1999 Number of screened neonates with a positive test at the last screening test prior to hospital discharge Number of screened neonates Overreferral
Referral rate before leaving the hospital
b) 4 % (when ABR is also used)
6 Referral rate for definitive audiological testing after screening <4 % AAP, 1999 and JCIH, 2007 Number of children sent to a definitive audiological evaluation Number of screened neonates (at net of all those lost to follow-up) Overreferral
Percentage of all newborn infants who fail initial screening and fail any subsequent rescreening before definitive audiological evaluation; the recommended benchmark is less than 4 %.
7 False-positive rate ≤3 % Adapted from AAP, 1999 Number of neonates with positive test at last screening test who have a negative definitive audiological evaluation (false positives) Number of screened neonates without disease (false positive plus true negativeb) at net of all those lost to follow-up. Resource consumption
False-positive rate related to the entire screening process
  1. aAmerican Academy of Pediatrics
  2. bWhen the true negatives are not available we have considered that all the negatives (i.e., all the screened minus the true positives and minus the lost to follow-up) are true negatives