Table 5.

Coordination and recommended evaluation based on a combined physiologic and genetic NBHS with a limited genetic screening panel

		Genetic newborn hearing screening result
		Negative (B/LB variants)	Uncertain (VUS; single P/LP variant not predicting a deafness phenotype, i.e., associated with AR deafness)	Positive (P/LP variants predicting deafness phenotype)
Physiologic newborn hearing screening result	Negative (Pass)	- Routine hearing surveillanceb	- Routine hearing surveillance - Genetic counseling if indicated by other symptoms or concerns	- Diagnostic audiometry - Long-term follow up - Genetic counseling
	Positivea (Fail/did not pass)	- Diagnostic audiometry - Further diagnostic deafness evaluation	- Diagnostic audiometry - Further diagnostic deafness evaluation - Genetic counseling	- Diagnostic audiometry - Long-term follow up - Genetic counseling

Screening tests are administered concurrently.

AR autosomal recessive, B/LB benign/likely benign, NBHS newborn hearing screening, P/LP pathogenic/likely pathogenic, VUS variant of uncertain significance.

^aBased on available data, we recommend congenital cytomegalovirus (cCMV) testing for all newborns who refer on physiologic NBHS.

^bRoutine hearing surveillance based on Joint Committee on Infant Hearing (JCIH) guidelines.