Delayed Diagnosis of Infants With Abnormal Neonatal Screens

Listernick, Robert

doi:10.1001/jama.1992.03480080065028

Cited by 15 publications

References 9 publications

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Quality Health Care

Laffel

Berwick²

1993

JAMA

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The U.S. has worse mortality rates than virtually all other developed nations, and yet it spends twice as much per capita on health care. How on earth has the U.S. racked up such an appallingly bad healthcare record, and what is the solution? A recent edition of the Journal of the American Medical Association (JAMA) identified many of the problems but was not persuasive in prescribing a cure.Let's look at what ails the U.S. health-care system and the difficulties one encounters when trying to fix it. Three solutions -transparent pricing, telemedicine, and resource rationing -could help improve cost and quality problems that the U.S. health care industry faces today. A litany of underperformanceThe Nov. 13 JAMA confirms the basic fact that the U.S. spends twice as much as other developed nations do on healthcare but has worse outcomes.As reported in an article in The Atlantic earlier this year, the United States has higher mortality rates in all population categories than do 16 other developed nations:

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Quality Health Care

Laffel

Berwick²

1993

JAMA

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Newborn Screening Programmes

Parsons¹,

Bradley²

2008

Encyclopedia of Life Sciences

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Newborn screening programmes are used to detect diseases in neonates by analysing a blood sample collected by heel‐prick, usually during the first week of life. Whereas early programmes were started with the aim of preventing mental retardation, advances in technology now mean that a variety of disorders, where treatment is more problematic, or even nonexistent, can be identified. This has broadened the scope of newborn screening and presents service providers with an increasing need to address issues about consent.

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Communication of positive newborn screening results for sickle cell disease and sickle cell trait: Variation across states

Kavanagh¹,

Wang²,

Therrell³

et al. 2008

American J of Med Genetics Pt C

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In the US, all states and the District of Columbia have universal newborn screening (NBS) programs for sickle cell disease (SCD), which also identify sickle cell trait (trait). In this project, we surveyed follow-up coordinators, including one in the District of Columbia and two in Georgia, about protocols for stakeholder notification for SCD and trait. The primary outcomes were total number and type of stakeholder informed of a positive screen. We received 52 completed surveys (100% response). Primary care providers (PCPs) (100%), hematologists (81%), hospitals (73%), and families (40%) were the most commonly notified stakeholders of positive SCD screens, while PCPs (88%), hospitals (63%), and families (37%) were most commonly notified for trait. On average, 3.4 stakeholders were notified for a positive screening for SCD, compared to 2.4 stakeholders for sickle cell trait (P < 0.001). In multivariate analyses for SCD, we found a 2.9% increase in stakeholders notified for each additional year of universal screening mandated in a state (95% CI: 1.4-4.4%). For trait, we found an 8.5% increase in stakeholders notified for each additional follow-up staff (95% CI: 1.3-15.7%), and a 1.3% increase for each additional percent of black births in the state (95% CI: 0.1-2.5%). Wide variation exists in stakeholder notification by NBS programs of positive screenings for SCD and trait. This variation may alter the effectiveness of NBS programs by location of birth.

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Delayed Diagnosis of Infants With Abnormal Neonatal Screens

Cited by 15 publications

References 9 publications

Quality Health Care

Quality Health Care

Newborn Screening Programmes

Communication of positive newborn screening results for sickle cell disease and sickle cell trait: Variation across states

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