Expanded newborn screening in Bavaria: tracking to achieve requested repeat testing.
OBJECTIVE
Expansion of newborn screening programs may increase the risk of missing cases through procedural failures. A coordinated process quality assurance procedure to track recalls was, therefore, introduced in parallel to expansion (including MS-MS and 17alpha-OHP) in Bavaria.


METHODS
Using comprehensive computerized registration and automated monitoring a state-funded center coordinated all individual measures to achieve complete testing of all repeat requests-case-specific contacts to physicians, midwives, and parents. Mailing and phoning from the center were supplemented by local public health activities including home visits if needed.


RESULTS
Among 243,422 children tested in 1999 and 2000 overall recall was 3.62% (8,809 children): 0.30% (726) were due to sample inadequacy, 1.35% (3,282) to early sampling (<48 h), and 1.97% (4,801) to abnormal results. Of all recalls, 80.9% were received following the initial request, 1,679 (19.1%) required special efforts. Of these, 873 were achieved following a single and 601 following repeated central activities, and 102 were achieved following local support. Sixty-three cases of parental refusal and 47 untraceable children remained. Altogether, 98.8% recalls were achieved, corresponding to 99.96% of all tested children for which definite screening results could be obtained.


CONCLUSIONS
Expansion of newborn screening programs does not necessarily mean unsolvable problems in tracking of recalls if adequate logistics is established in parallel.
Liebl
Bernhard
B
Public Health Newborn Screening Center of the State of Bavaria, Landesuntersuchungsamt Südbayern, D-85762 Oberschleissheim, Germany. bernhard.liebl@t-online.de
Nennstiel-Ratzel
Uta
U
von Kries
Rüdiger
R
Fingerhut
Ralph
R
Olgemöller
Bernhard
B
Zapf
Andreas
A
Roscher
Adelbert A
AA
D005858:Germany; D006801:Humans; D007231:Infant, Newborn; D013058:Mass Spectrometry / Q000706:statistics & numerical data*; D015997:Neonatal Screening / Q000458:organization & administration* / Q000706:statistics & numerical data; D010349:Patient Compliance; D020458:Third-Party Consent