Hearing and Functioning in Everyday Life Questionnaire: Development and Validation of an ICF-Based Instrument.

OBJECTIVES: Self-assessment instruments are commonly used in audiological rehabilitation. However, several studies highlight the lack of multidimensionality in existing outcome measures, with the consequence that they only partially capture aspects of functioning in everyday life for people living with hearing loss. This study aimed to develop and investigate the content validity of a self-assessment instrument based on the validated Brief International Classification of Functioning, Disability, and Health Core Set for Hearing Loss. DESIGN: The design was a two-part instrument development study. The first part focused on the item-generation process of the instrument, named the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) during an experts' workshop. The second part focused on international content validation of the instrument using group interviews. Strategic sampling was used and 30 adults with hearing loss from India, South Africa, and the United States participated in the group interviews. RESULTS: The expert's workshop resulted in the first version of the HFEQ containing 30 items. The results from group interviews show that the content of the HFEQ was considered to be valid concerning its relevance, comprehensiveness, and comprehensibility. A majority (73%) of the HFEQ items were perceived by the participants as relevant and easy to comprehend. For the remaining 27% of the items, the content was perceived to be relevant in all countries, but some terms and expressions were reported to require rewording or clearer examples. These modifications will be made in the next step of the development process. CONCLUSION: Content validation of the HFEQ demonstrates promising results, with participants perceiving the content as relevant and comprehensible. Further psychometric validation is required to investigate other psychometric properties, such as construct validity and reliability. The HFEQ has the potential to become a valuable new instrument for assessing everyday functioning in people with hearing loss in audiological rehabilitation and in research.

Validation of the Brief International Classification of Functioning, Disability and Health (ICF) core set for hearing loss: an international multicentre study.

OBJECTIVE: Hearing loss (HL) affects the everyday functioning of millions of people worldwide. The Brief International Classification of Functioning Disability and Health (ICF) core sets for HL was developed to meet the complex health care needs of adults with HL. Because the brief core set for HL has not yet been validated internationally, this study aimed to investigate its validity from an international perspective. DESIGN: A cross-sectional validation study based on data from structured interviews with adults with HL. STUDY SAMPLE: Participants (n = 571) from India, South Africa, Sweden and the US were included. RESULTS: A six-factor solution explained 71% of the variance, focussing on issues related to communication, the social environment, participation in society, health care services, support, relationships and emotions (α = 0.915). Three ICF categories demonstrated low reliability - temperament and personality functions, seeing functions and school education. CONCLUSION: The Brief ICF core set for HL is valid for adults with HL internationally. However, to further increase its international validity, we recommend adding the categories d920 recreation and leisure and replacing d850 school education with the more inclusive block, d810-d839 education.

Knowledge and attitude of parents/caregivers towards hearing loss and screening in newborns - a systematic review.

OBJECTIVE: The parents/caregivers of a newborn play a pivotal role in the process of hearing screening and intervention. The decisions taken by them depend on their knowledge and attitude. The purpose of this study was to review the literature systematically on knowledge and attitude of parents/caregivers towards infant hearing loss and newborn hearing screening. DESIGN: A systematic search was conducted using electronic databases for the periods from 1990 to March 2016. Two authors scrutinized the studies and extracted the data based on predetermined criteria. STUDY SAMPLE: Ten studies. RESULTS: Ear discharge was correctly identified as a risk factor for hearing loss along with measles, drugs/medication, family history, congenital causes and noise exposure. The studies revealed mixed results for knowledge about newborn hearing screening. Overall, the parents/caregivers showed positive attitudes towards hearing screening and intervention options. However, due to heterogeneity in the studies, it's hard to derive a conclusion. CONCLUSIONS: The present review sheds light on the common areas of misconception among parents/caregivers about risk factors of infant hearing loss and newborn hearing screening. The review also draws attention to the need to have more studies exploring this knowledge and attitude of parents/caregivers among diverse populations.

Impact of Hearing Loss on Social Participation in Children: A Scoping Review.

Social participation can be defined as involvement in activities that provide a platform to interact with society and others. Untreated hearing loss effects communication skills, academic achievements, and peer-group interaction. Since a typical body structure and body functioning are essential to demonstrate day to day activities. Altogether these factors can influence the social participation in children with HL. The aim of this study is to systematically review the impact of hearing loss on social participation in children.A literature search was carried out to obtain studies exploring social participation among children with HL. Two authors independently searched four electronic databases, PubMed, Scopus, Embase, and Web of Science. The search strategy was designed by using six main terms 'social participation', 'social engagement', 'social interaction', 'hearing loss', 'hearing impairment', 'hearing disorder', and Boolean operators 'AND', 'OR' were used to make the search strings. The current review included four studies after meeting the eligibility criteria. Findings showed that social participation is affected in children with HL. Reduced hearing ability is one of the factors of reduced social participation in children. Children using hearing aids or cochlear implants, participate more frequently in social activities. The findings of this review suggest that HL is associated with reduced social participation. However, using hearing aids and cochlear implants followed by auditory verbal therapy has significant improvement in social participation. Future studies need to investigate whether early rehabilitation can increase social participation in children.

Self-esteem among Individuals with Hearing Loss: A Systematic Review.

Purpose: Self-esteem is important for decision making, emotional health, and overall well-being. In individuals with hearing loss (HL), self-esteem may vary due to degree of HL, hearing devices, academic set-ups and communication strategies used by family members. This study aimed to systematically review the impact of hearing loss on self-esteem. Method: A systematic search was conducted to identify the studies focusing on self-esteem of the individuals with HL. Four electronic databases, PubMed, Scopus, Embase, and CINAHL, were used. Title screening and abstract reading were performed by two independent authors. Appropriate studies were considered for full-length reading. The references of the obtained articles were manually searched to identify eligible studies. A mixed-methods appraisal tool was used to critically appraise the included studies. Results: Out of 1219, twelve studies met the inclusion criteria. Individuals with HL exposed to total communication had a positive impact on self-esteem. Interestingly, hearing competence of parents and siblings was linked with their self-esteem. Children with HL have higher self-esteem than normal-hearing children. Children with HL attending mainstream schooling and using cochlear implants had positive and higher self-esteem. Further, higher education level, employment, and marital status were effectively associated with self-esteem. Conclusion: Positive self-esteem intensely improves mental and emotional well-being. Appropriate and timely provided rehabilitation accompanied by family support can induce healthier and more fulfilling social life. Additionally, healthy self-esteem can empower individuals with HL to engage in social activities diligently. To sum up, early intervention and family participation are required to improve overall quality of life.

Accuracy and Consistency of Confidence Limits for Monosyllable Identification Scores Derived Using Simulation, the Harrell-Davis Estimator, and Nonlinear Quantile Regression.

BACKGROUND: Audiological diagnosis and rehabilitation often involve the assessment of whether the maximum speech identification score (PBmax) is poorer than expected from the pure-tone average (PTA) threshold. This requires the estimation of the lower boundary of the PBmax values expected for a given PTA (one-tailed 95% confidence limit, CL). This study compares the accuracy and consistency of three methods for estimating the 95% CL. METHOD: The 95% CL values were estimated using a simulation method, the Harrell-Davis (HD) estimator, and non-linear quantile regression (nQR); the latter two are both distribution-free methods. The first two methods require the formation of sub-groups with different PTAs. Accuracy and consistency in the estimation of the 95% CL were assessed by applying each method to many random samples of 50% of the available data and using the fitted parameters to predict the data for the remaining 50%. STUDY SAMPLE: A total of 642 participants aged 17 to 84 years with sensorineural hearing loss were recruited from audiology clinics. Pure-tone audiograms were obtained and PBmax scores were measured using monosyllables at 40 dB above the speech recognition threshold or at the most comfortable level. RESULTS: For the simulation method, 6.7 to 8.2% of the PBmax values fell below the 95% CL for both ears, exceeding the target value of 5%. For the HD and nQR methods, the PBmax values fell below the estimated 95% CL for approximately 5% of the ears, indicating good accuracy. Consistency, estimated from the standard deviation of the deviations from the target value of 5%, was similar for all the methods. CONCLUSIONS: The nQR method is recommended because it has good accuracy and consistency, and it does not require the formation of arbitrary PTA sub-groups.

Knowledge, Beliefs, and Practices Towards Cochlear Implantations Among Otorhinolaryngologists in India.

The outcome of the cochlear implant is dependent highly on the knowledge, belief and practice of cochlear implant in otolaryngologists who are among the important team members. The study explored the knowledge, beliefs, and practices towards cochlear implantations among otorhinolaryngologists in India. An online cross-sectional survey study was carried out using convenient sampling among otorhinolaryngologists in India. Phase-I involved developing and validating of a questionnaire to study the knowledge, beliefs, and practices towards cochlear implants among otorhinolaryngologists in India while phase II involved administration of the questionnaire and analysis. Data collection was conducted using Google Forms. A total of 106 otorhinolaryngologists participated across 24-65 years of age and with experience ranging from 1 to 42 years. The participating otorhinolaryngologists reported having good knowledge about the candidacy for a cochlear implant but having limited knowledge of the recent developments and governmental schemes. The otorhinolaryngologists displayed positive beliefs regarding cochlear implantation. Most recommended a battery of tests to determine the candidacy and gave a lot of importance to rehabilitation (96.2%) and surgery for implantation (83%). The respondents also practiced giving importance to a team approach involving multiple team members. High costs and financial burden emerged to be the major challenges for cochlear implantation in India. The findings of the survey indicate an overall positive belief and practices towards cochlear implantation by otorhinolaryngologists in India. However, there is a need to spread more awareness among them about the recent advances and schemes that would further improve their service delivery.

Cervical Vestibular-Evoked Myogenic Potentials in Individuals with Diabetes Mellitus: A Systematic Review and Meta-Analysis.

Vestibular evoked myogenic potentials (VEMPs) in individuals with diabetes mellitus (DM) provide evidence as how diabetes can bring about changes in the peripheral nervous system. Cervical VEMP (cVEMP) evaluates the function and integrity of the sacullo- collic pathway and ocular VEMP (oVEMP) evaluates the utriculo-collic pathway. cVEMP is an ipsilateral inhibitory response of the sternocleidomastoid muscle. cVEMP is recorded at higher intensity above 80-85 dBnHL with biphasic waveforms having initial peak positivity P13 followed by a negativity N23. We performed a systematic review following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to evaluate cVEMP in diabetes mellitus. The search was conducted in the databases: PubMed, Cumulative Index of Nursing and Allied Health Literature, Scopus, and Cochrane library using the keywords "diabetes mellitus" and "vestibular evoked myogenic potential" or "cVEMP." A two-phase selection process was used for the final inclusion of studies, and the methodological quality of these studies was assessed using the Newcastle Ottawa scale (NCOS). Meta-analysis was performed using a random-effects model. For comparisons between DM and healthy controls, a significant difference was observed for cVEMP amplitude (P = 0.01). Our meta-analysis's results suggest peripheral vestibular dysfunction can be observed in DM. It appears that cVEMPs may be useful in the early detection of neuropathy in DM.

Auditory cortical stimulability in non habilitated individuals - An evidence from CAEPs.

Objective: The effect of long term auditory deprivation on Cortical Auditory Evoked Potentials (CAEPs) especially in human models is not well explored. Hence, the current study was aimed to investigate the effects of long-term auditory deprivation and stimulability of auditory cortex in non habilitated congenitally deaf adolescents and adults using CAEPs. Methods and Results: A total of 27 non-habilitated congenitally deaf adolescents/adults with age and gender matched normal hearing adolescents/adults participated in the study. The congenitally deaf group was fitted with high gain hearing aids (first fit). Further, the CAEPs were recorded. The obtained CAEP components were assessed for group effect, source and topographical differences. The between group analysis for CAEP responses showed a significant difference only for P2 latency and amplitude. The source analysis revealed that, in the normal hearing group for CAEPs, the sources were within the temporal regions. However, in the congenitally deaf group, along with the temporal cortex, the bilateral prefrontal cortex also was activated. Conclusion: The findings revealed that it is possible to stimulate and evoke a matured CAEP response from a long deprived auditory system with adequate acoustic stimulation. The presence of CAEP responses is indicative of the functionality of the innate auditory pathway and the crossmodal plasticity in long auditory deprived individuals.

Impact of COVID-19 pandemic on audiology practice: A scoping review.

BACKGROUND: COVID-19 has significantly impacted the professional practice of health care professionals including audiological practice. Audiologists had to adopt to changes and modify their practice to deal with the pandemic. Reasonable published work has been seen since the onset of the pandemic, depicting impact on the audiology practice across the globe in different practice settings and contexts. The present scoping review was carried out to explore the impact of COVID-19 pandemic on audiology practice and the challenges faced. MATERIAL & METHODS: A literature search was carried out to identify the studies exploring the impact of COVID-19 pandemic on audiology practice. Three electronic databases namely Scopus, PubMed/Medline, and Cochrane Library were searched using keywords. After title and abstract screening, suitable studies were identified. RESULTS: Of the total 172, nine studies focusing on impact of COVID-19 pandemic on audiology practice COVID-19, published between January 2020 to June 2021 were included. Overall, the COVID-19 pandemic and the subsequent restrictions, caused changes in routine clinical practices in audiology. These changes were with respect to stringent infection control measures, mode of service delivery, changes in routines with reduced services or prioritizing services. Challenges included issues with remote services, experience, and support. CONCLUSION: The present review reveals the changes in audiology practice during COVID -19 and challenges encountered by audiologists. These findings would help in better planning of audiology practice in the post pandemic world.

Universal Newborn Hearing Screening: An Indian Experience of Conceptualizing and Testing a Comprehensive Model.

There have been isolated attempts to implement newborn hearing screening at various setups across India. However, none of these attempts has followed a holistic model comprising of multiple components. Therefore, a need was felt to design and implement a comprehensive universal newborn hearing-screening model to, improve follow-up, and provide practically implementable solutions for developing economies. The model was conceptualized after a detailed preliminary planning level. Separate protocols for newborns from well-baby nursery and neonatal intensive care unit were implemented. Measures were implemented to improve follow-up. Knowledge, attitude, and practices survey followed by a sensitization program was carried out to highlight the importance of newborn hearing screening among the healthcare providers. A knowledge and attitude survey was also carried out among mothers. The estimated prevalence rate was 8.78 per 1000. Measures enabled an improved follow-up rate that lead to a reduced age of identification to 6 months. The surveys among mothers and healthcare providers helped to identify the lacunae in knowledge levels, which need to be filled in order to improve their attitudes. Thus, this was a successful model for universal newborn hearing screening comprising of two-stage screening, separate protocols, steps to improve follow-up, improving awareness among parents, sensitization programs, and surveys among mothers as well as healthcare providers.

Impact of coronavirus disease 2019 on professional practices of audiologists and speech-language pathologists in India: A knowledge, attitude and practices survey.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread throughout the world and become a global pandemic. This has hampered and led to drastic changes in the functioning of healthcare services, forcing the professionals to adapt and work efficiently. The present study aimed to explore the impact of COVID-19 on the professional practices of audiologists and speech-language pathologists in India using a cross-sectional knowledge, attitude and practices survey. MATERIAL AND METHODS: The study was conducted in two phases; phase one involved development and validation of the questionnaire, while phase II involved data collection. A cross-sectional self-reported internet-based study using convenience sampling was carried out. RESULTS: Two hundred and eleven audiologists and speech-language pathologists responded to the survey. Overall, the professionals exhibited good knowledge levels regarding the COVID-19 outbreak. However, there were differences in their attitudes towards service delivery in the midst of the pandemic. Further, poor practices towards infection control measures especially in terms of hand washing was noted. CONCLUSION: The findings of the present study are useful in highlighting the need to create better awareness among these professionals about appropriate and standard infection control measures. There is a need to have in place standard operating protocols for hand wash and infection control as well as inclusion in curriculum.

Evaluation and Management of Patients with Diabetes and Hearing Loss.

Diabetes mellitus is a significant risk factor for acquired hearing loss and tinnitus. Persons with diabetes (PWD) may present with hearing loss symptoms earlier in life than those without diabetes. Furthermore, diabetes may exacerbate risk for hearing loss related to noise exposure and ototoxic drugs. The purpose of this article is to provide recommendations for the prevention, screening, evaluation, and management of hearing loss in PWD.

A Preliminary Attempt to Profile Tympanometric Measures in Infants Using High Frequency Probe Tones.

There is dearth of published data on high frequency tympanometric measures for infants in Indian context. Aim of present study was to profile Peak compensated static acoustic admittance (Ytm), Tympanometric peak pressure (TPP), Tympanometric width (TW) and Equivalent ear canal volume (Vea) in infants. Cross-sectional study on 50 infants with present TEOAEs and with risk indicators for hearing loss. Tympanometry was performed using GSI-Tympstar for 678 and 1000 Hz probe tones. Descriptive statistics were used to determine mean, SD and minimum and maximum for both genders. Using 678 Hz, Ytm ranged from 0.09 to 1. 48 mmho (males) and 0.11 to 1.14 mmho (females), while with 1000 Hz ranged from 0.15 to 1.49 (males) and 0.13-1.61 mmho (females). Using 678 Hz, TPP ranged from -95 to 70 daPa (males) and -155 to 80 daPa (females), while with 1000 Hz ranged from -75 to 95 daPa (males) and -145 to 50 daPa (females). Using 678 Hz, TW ranged from 30 to 190 daPa (males) and 40-23 daPa (females), while with 1000 Hz ranged from 60 to 210 daPa (males) and 40-183 daPa (females). Using 678 Hz, Vea ranged from 0.11 to 1.7 mmho (males) and 0.14-2.5 mmho (females), while with 1000 Hz ranged from 0.14 to 2.0 mmho (males) and 0.14-3.6 mmho (males). This study was a preliminary attempt to profile the tympanic measures. Ytm values were lesser or similar to other studies, TPP and Vea values had lower and narrow range, while TW were more than previous studies.

Systematic review of knowledge of, attitudes towards, and practices for newborn hearing screening among healthcare professionals.

INTRODUCTION: The success of newborn hearing screening programs lies in the timely identification, diagnosis, and management of children with hearing loss accomplished via a multidisciplinary newborn hearing screening (NHS) team. The team is typically comprised of various healthcare professionals who act as decision makers as well as facilitators for different stages in the screening process. Team members' knowledge of, attitudes towards, and practices for early hearing detection and intervention programs are critical for success and prevention of loss to follow up. In this context, it becomes crucial to understand their knowledge of, attitudes towards, and practices for towards newborn hearing screening. METHODS: A systematic review was conducted on the following databases; PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, Science Direct and Cochrane Library. This search was carried out using various keywords such as practitioners, newborn hearing screening, knowledge, attitudes, and practices in different combinations. The review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines. RESULTS: A total of 271 hits were obtained of which 20 articles were found suitable for inclusion in the final review. Overall, similar results were found regarding team members' knowledge of NHS programs, regardless of country of origin. Similarly, attitudes toward NHS programs were positive. Team members' experiences with NHS programs varied from country-to-country and across healthcare professionals. Results consistently showed gaps in team members' knowledge suggesting the need for outreach and professional education programs on NHS. CONCLUSION: NHS teams members from different countries, healthcare systems, and early hearing detection and intervention programs show gaps in critical knowledge warranting outreach and educational programs.

Knowledge and Perceptions of Teleaudiology Among Audiologists: A Systematic Review.

BACKGROUND AND OBJECTIVES: The knowledge and perception of teleaudiology among audiologists will determine the acceptance and success of teleaudiology practice. This systematic review was conducted to review the published literature on knowledge and perceptions of teleaudiology application among audiologists. MATERIALS AND METHODS: Five studies exploring knowledge and perceptions of teleaudiology application among audiologists published in the English language up to May 2017 were included. RESULTS: Positive attitudes was observed across the studies regarding acceptance towards application of teleaudiology. The most common sources of knowledge were on the job, graduate studies, and continuing education programs. The major barriers to the uptake of application of teleaudiology were in terms of limitations in infrastructure, reimbursement, and licensure. CONCLUSIONS: The study sheds light on the existing knowledge and perceptions of teleaudiology applications among audiologists. This will help in improving the existing teleaudiology services as well as overcome the challenges faced.

A national survey of knowledge, attitude and practices among pediatricians towards newborn hearing screening in India.

INTRODUCTION: Pediatricians have a key role in ensuring that infant has undergone hearing screening and required follow-up. Attempts in various countries and centers have been made at exploring their knowledge, attitude and practices towards universal newborn hearing screening. In India, such a program is at its preliminary stage, and hence a need was felt to study this aspect in pediatricians working in India. METHOD: A cross-sectional online survey was carried out among 112 pediatricians working in India. The questionnaire was framed after reviewing the existing questionnaires. Descriptive statistics was used to summarize the findings. RESULTS: A response rate of 7.99% (112/1402) was obtained of which only 20.5% reported of availability of screening program in their work set-up. The majority of the pediatricians (95%) were aware of the newborn hearing screening while 98.3% were affirmative about the importance of screening of all infants. Very few pediatricians reported of a screening program in their set-up or in their close locality. Overall the pediatricians were confident about their knowledge on this topic yet expressed a need to know more about several intricacies about hearing screening. The pediatricians also provided an input on the most preferred method of receiving more information. SUMMARY AND CONCLUSION: The success of the universal newborn hearing screening program lies in the support and cooperation of health care providers such as pediatricians. The present study draws attention to the positive attitude and practices exhibited by them. It also sheds light on the knowledge gaps that are present and need the due attention of the policy makers. Further, it highlights the need for having more continuing medical education program and awareness drives for ensuring a better implementation of UNHS.

The Effect of Intensity on the Speech Evoked Auditory Late Latency Response in Normal Hearing Individuals.

OBJECTIVE: Among the stimulus factors, the influence of presentation level is less studied in normal-hearing individuals when using speech stimuli withvarious presentation levels for the auditory late latency response (ALLR). Hence, the present study aimed to explore the Latency-Intensity (L-I) function, i.e., how the latency and amplitude change as a function of intensity using speech stimuli. MATERIALS AND METHODS: Speech-evoked ALLR was obtained from 15 normal-hearing individuals. The syllable/ta/ was used to record ALLR with an intensity of 30, 50, 70, and 90 dBSPL. Electroencephalography (EEG) from five channels was recorded and analyzed offline. RESULTS: The overall results revealed that there is an influence of intensity on P1 and N1 latencies in a nonlinear fashion. The latency change is consistent at lower intensities than at moderate and high intensities. The amplitude changes did not reach significance, though a decrease with a reduction in intensity was obvious. CONCLUSION: There is a significant effect of intensity on the latency and amplitude of ALLR in speech stimulus. However, this effect may vary for different speech stimuli.

Knowledge and attitude (KA) survey regarding infant hearing loss in Karnataka, India.

INTRODUCTION: The support provided and the decisions taken by mothers determine the success of Universal Newborn Hearing Screening (UNHS). Attempts at exploring the existing knowledge-attitude among mothers is crucial to create/modify the existing screening programs. The present study attempts to explore the knowledge and attitude toward infant hearing loss (HL) among mothers of newborns in the Indian state of Karnataka. METHOD: A cross-sectional survey was conducted among 219 mothers of newborns in Karnataka, India. The questionnaire was framed from existing literature and consisted of 19 questions assessing knowledge and attitude toward infant HL to be rated on a three-point scale (no, not sure, yes). Descriptive statistics and Cronbach's α were used to analyze the data. RESULTS: Mothers exhibited good knowledge of risk factors; noise (70.3%) and ear discharge (54.3%). More than 75% agreed that treatment for HL is available and that these children can attend school. The questions of superstitions and cultural beliefs yielded mixed responses. A large number of mothers expressed desire to have their children tested at birth (84.9%) and were concerned about their children's hearing (87.7%). Yet only 54.3% stated that they would allow their children to wear hearing aids. SUMMARY AND CONCLUSION: The present study is an attempt to understand the knowledge and attitude of mothers toward infant HL in Karnataka and facilitate identification of potential areas of less knowledge as a reference for endeavors of enhancement. It further highlights the need for implementing public awareness programs to improve knowledge and attitude of mothers toward infant HL for better implementation of UNHS.

Follow-up in newborn hearing screening - A systematic review.

INTRODUCTION: 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. CONCLUSION: 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.