Evidence or enthusiasm? Why yields from UK newborn screening programmes for congenital hypothyroidism are increasing
| Autor: | Rodney J Pollitt |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Referral Thyrotropin 030209 endocrinology & metabolism 03 medical and health sciences Neonatal Screening 0302 clinical medicine 030225 pediatrics Congenital Hypothyroidism medicine Humans Sex Distribution Newborn screening Evidence-Based Medicine business.industry Incidence Thyroid disease Incidence (epidemiology) Public health Infant Newborn medicine.disease Infant newborn United Kingdom Congenital hypothyroidism Pediatrics Perinatology and Child Health Female business Clinical evaluation Biomarkers |
| Zdroj: | Archives of Disease in Childhood. 101:120-123 |
| ISSN: | 1468-2044 0003-9888 |
| Popis: | Newborn screening for congenital hypothyroidism (CHT) is generally regarded as a highly successful public health measure. It was officially added to the UK newborn screening programme for phenylketonuria in 19811 though many areas had already started. A two-tier protocol based on assay of thyrotropin (thyroid-stimulating hormone, TSH) was recommended, with a second blood-spot sample taken at 2–6 weeks of age from babies with borderline initial results. As found elsewhere in Europe, the incidence of screening-detected cases in the early years was approximately double that of the clinically diagnosed disorder (table 1). View this table: Table 1 Incidences of clinically diagnosed and screening presumptive-positive cases of congenital hypothyroidism Presumptive-positive rates (cases referred for clinical evaluation) have increased further over time, partly because many laboratories lowered their primary cut-offs as more sensitive TSH assays became available.6–9 However, other changes have contributed as the Sheffield newborn screening laboratory has experienced increased presumptive-positive rates even though the primary cut-off has remained unchanged. The Sheffield region laboratory serves the East Midlands and South Yorkshire and has screened between 55 000 and 75 000 babies a year. The screening protocol (figure 1) follows the outline scheme recommended in 1981.1 Between 1980 and 1985 (inclusive), the Pharmacia Phadebas Dry-Spot TSH assay was used, with 10 mU/L primary and second sample cut-offs and 40 mU/L as the secondary cut-off leading to immediate clinical referral. Incidence and sex ratios were broadly similar to those recorded for 1982–1984 by the UK Medical Research Council (MRC) Register5 and from Wales10 and Scotland11 over longer periods. Figure 1 Outline of the laboratory protocol for screening for congenital hypothyroidism. Usually the primary cut-off value is used also for the second-sample cut-off. TSH, thyroid-stimulating hormone. From August 2001 onwards, Sheffield used the Perkin-Elmer DELFIA assay, with either AutoDELFIA or Perkin-Elmer Genetic Screening Processor instrumentation, and a secondary cut-off of 20 mU/L … |
| Databáze: | OpenAIRE |
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