title: Screening for critical congenital heart disease:  advancing detection in the newborn.
abstract: OBJECTIVE
  Screening for critical congenital heart disease (CCHD) using pulse oximetry was added to the recommended uniform screening panel through an endorsement by the Health and Human Services Secretary in September 2011. As organizations on both the macrolevels and microlevels consider implementation, research efforts and professional endorsements have been completed, providing important guidance moving forward.
  
  
  RESULTS
  Screening for CCHD has been endorsed by the American Heart Association, American College of Cardiology, March of Dimes and American Academy of Pediatrics. In addition, strategies for best practice regarding implementation and a screening protocol for well babies are now available. Screening for CCHD as a complement to existing mechanisms has been added without need for additional staff, associated with improved detection, and shown to be cost effective with an incremental cost-effectiveness ratio of £24 000. Hospitals in Wisconsin assessed their readiness and reported that all had pulse oximetry equipment onsite and 74.4% had access to same-day neonatal echocardiography. Infants in neonatal care units need further consideration, as there were reports of CCHD missed.
  
  
  CONCLUSIONS
  CCHD screening is easily implemented in community hospitals, and is cost effective, and some states may be better prepared for implementation than previously hypothesized.
authors.affiliation: Children's National Medical Center, George Washington University School of Medicine, Washington, District of Columbia 20010, USA. ebradsha@childrensnational.org
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Bradshaw
authors.forename: Gerard R
authors.initials: GR
authors.lastname: Martin
mesh_terms: D000572:American Heart Association; D003362:Cost-Benefit Analysis; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D015997:Neonatal Screening / Q000191:economics; D010092:Oximetry / Q000191:economics; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology