“…This approach has the advantage of a high initial participation rate as reported to be on average > 95% across UNHS programs as evidenced in systematic reviews [11,12]. The disadvantage, however, is that the inpatient protocol often takes place within the first two days of life which increases the risk of falsenegative test results [14,15,16,17] This is due to the fact, that many screening programs have adopted OtoAcustic Emissions (OAE) as the measurement of choice for the initial screening [12,14]. OAE measurements are sensitive to obstructions in the ear canal and middle ear, due to birth debris, amniotic fluid and mucus which is most prominent in the first few hours to days of life [17,18].…”