title: Strategies for implementing screening for critical congenital heart disease.
abstract: BACKGROUND
  Although newborn screening for critical congenital heart disease (CCHD) was recommended by the US Health and Human Services Secretary's Advisory Committee on Heritable Disorders in Newborns and Children to promote early detection, it was deemed by the Secretary of the HHS as not ready for adoption pending an implementation plan from HHS agencies.
  
  
  OBJECTIVE
  To develop strategies for the implementation of safe, effective, and efficient screening.
  
  
  METHODS
  A work group was convened with members selected by the Secretary's Advisory Committee on Heritable Disorders in Newborns and Children, the American Academy of Pediatrics, the American College of Cardiology Foundation, and the American Heart Association.
  
  
  RESULTS
  On the basis of published and unpublished data, the work group made recommendations for a standardized approach to screening and diagnostic follow-up. Key issues for future research and evaluation were identified.
  
  
  CONCLUSIONS
  The work-group members found sufficient evidence to begin screening for low blood oxygen saturation through the use of pulse-oximetry monitoring to detect CCHD in well-infant and intermediate care nurseries. Research is needed regarding screening in special populations (eg, at high altitude) and to evaluate service infrastructure and delivery strategies (eg, telemedicine) for nurseries without on-site echocardiography. Public health agencies will have an important role in quality assurance and surveillance. Central to the effectiveness of screening will be the development of a national technical assistance center to coordinate implementation and evaluation of newborn screening for CCHD.
authors: Duke Clinical Research Institute and Department of Pediatrics, Duke University, Durham, NC 27705, USA. alex.kemper@duke.edu
authors: Alex R
authors: AR
authors: Kemper
authors: William T
authors: WT
authors: Mahle
authors: Gerard R
authors: GR
authors: Martin
authors: W Carl
authors: WC
authors: Cooley
authors: Praveen
authors: P
authors: Kumar
authors: W Robert
authors: WR
authors: Morrow
authors: Kellie
authors: K
authors: Kelm
authors: Gail D
authors: GD
authors: Pearson
authors: Jill
authors: J
authors: Glidewell
authors: Scott D
authors: SD
authors: Grosse
authors: R Rodney
authors: RR
authors: Howell
mesh_terms: D000572:American Heart Association; D005260:Female; D017144:Focus Groups; D006284:Health Plan Implementation; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D015997:Neonatal Screening / Q000458:organization & administration*; D010092:Oximetry / Q000379:methods*; D010101:Oxygen Consumption / Q000502:physiology; D011320:Primary Health Care; D015397:Program Evaluation; D011786:Quality Control; D018570:Risk Assessment; D012720:Severity of Illness Index; D014481:United States