title: Effects of immediate telephone follow-up with providers on sweat chloride test timing after cystic fibrosis newborn screening identifies a single mutation.
abstract: OBJECTIVE
  To assess whether reporting "possible cystic fibrosis (CF)" newborn screening (NBS) results via fax plus simultaneous telephone contact with primary care providers (PCPs) versus fax alone influenced 3 outcomes: undergoing a sweat chloride test, age at sweat chloride testing, and undergoing sweat testing before age 8 weeks.
  
  
  METHODS
  This was a retrospective cohort comparison of infants born in Wisconsin whose PCP received a telephone intervention (n = 301) versus recent historical controls whose PCP did not (n = 355). Intervention data were collected during a longitudinal research and quality improvement effort; deidentified comparison data were constructed from auxiliary NBS tracking information. Parametric and nonparametric statistical analyses were performed for group differences.
  
  
  RESULTS
  Most infants (92%) with "possible CF" NBS results whose PCP lacked telephone intervention ultimately underwent sweat testing, underlining efficacy for fax-only reporting. Telephone intervention was significantly associated with improvements in the infants undergoing sweat testing at age ≤6 weeks and <8 weeks and a slight, statistically nonsignificant 3.5-day reduction in the infants' age at sweat testing. The effect of telephone intervention was greater for PCPs whose patients underwent sweat testing at community-affiliated medical centers versus those whose patients did so at academic medical centers (P = .008).
  
  
  CONCLUSIONS
  Reporting "possible CF" NBS results via fax plus simultaneous telephone follow-up with PCPs increases the rate of sweat chloride testing before 8 weeks of age, when affected infants are more likely to receive full benefits of early diagnosis and treatment.
authors.affiliation: Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Alison
authors.initials: A
authors.lastname: La Pean
authors.forename: Michael H
authors.initials: MH
authors.lastname: Farrell
authors.forename: Kerry L
authors.initials: KL
authors.lastname: Eskra
authors.forename: Philip M
authors.initials: PM
authors.lastname: Farrell
mesh_terms: D002712:Chlorides / Q000032:analysis*; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000175:diagnosis* / Q000235:genetics; D005260:Female; D058015:Health Communication / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009154:Mutation; D015997:Neonatal Screening / Q000379:methods*; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care; D012107:Research Design / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013542:Sweat / Q000737:chemistry*; D016636:Telefacsimile; D013689:Telephone; D014922:Wisconsin
chemical_list: D002712:Chlorides