Independent Analysis FAIL PASS Initial Screen 77,148 18 174 76,956 25 Repeat Screen 174 76,956 Repeat Screen 25 149 Our independent analysis corrected for those errors in provider interpretation and excluded infants with insufficient pulse oximetry data leaving 77,148 infants. Following the AAP algorithm, we classified infants as passing, failing due to sat <90%, or having an indeterminate screen requiring repeat screening. We completed this for each repeat screen to determine the total number of positive and negative screens. Non-Pass 16 9 Total Positive 34 Total Negative 77,114

Modifying the Algorithm Initial Screen 77,148 18 Repeat Screen 174 76,956 Repeat Screen 25 149 We noted among the infants with failed screens due to sat <90%, including the true positive, all were identified on the initial screen. Eliminating the final repeat screen would not have missed any infants that are theoretically most likely to have significant disease. Non-Pass 16 9 Total Positive 34 Total Negative 77,114

Modified Algorithm Total Positive 43 18 Non-Pass 25 Initial Screen 77,148 18 Repeat Screen 174 76,956 Non-Pass 25 149 And eliminating that screen would only add an additional 9 infants who would have required further evaluation. Total Positive 43 Total Negative 77,105

Comparing Algorithms Sensitivity 14.3% False Positive Rate Current AAP Algorithm Modified Algorithm Sensitivity 14.3% False Positive Rate 1 in ~2500 births (0.043%) 1 in ~2000 births (0.054%) When compared to the current algorithm, there was no change in the sensitivity of screening and though the false positive rate would increase slightly, it has minimal impact with only an additional 2-3 infants requiring additional evaluation each year.