title: Development of a Newborn Screening Program for Critical Congenital Heart Disease (CCHD) in Taipei.
abstract: BACKGROUND
  Early detection of critical congenital heart disease (CCHD) can significantly reduce morbidity and mortality among newborns. We investigate the feasibility of implementing a community-based newborn CCHD screening program in Taipei.
  
  
  METHODS
  Twelve birthing facilities in Taipei participated in a trial screening program between October 1, 2013, and March 31, 2014. Newborns underwent pulse oximetry at 24-36 h old, with probes attached to the right hand and one lower limb. Any screening saturation ≥95% in either extremity, with an absolute difference of ≤3% between the right hand and foot, was accepted as a screening pass. A screening result was considered as a fail if the oxygen saturation was <95% at either probe site, on 3 separate occasions, each separated by 30 min or the first result was <95% at either probe site, and any subsequent oxygen saturation measurement was <90%. Public health nurses would follow up all missed or refused cases.
  
  
  RESULTS
  Of the 6,387 live births, 6,296 newborns (coverage rate: 6,296/6,387 = 98.6%) underwent appropriate pulse oximetry screening. Sixteen newborns (0.25%) were reported to have a failed screening result. Five of these screen positive newborns were confirmed with CCHD; two of them were diagnosed solely attributed to the failed screening results. The false-positive rate was 0.18%. Implementing a 6-month screening program for CCHD produced good case detection rate, while using efficient screening and referral systems.
  
  
  CONCLUSIONS
  This program was successful in integrating screening, referral and public health tracking systems. The protocol outlined in this report could provide a community-based model for worldwide implementation.
authors.affiliation: Division of General Pediatrics, Pediatrics Department, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Institute of Physiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Pei-Chen
authors.initials: PC
authors.lastname: Tsao
authors.affiliation: Preventive Medicine Foundation, Taipei, Taiwan.
authors.forename: Yu-Shih
authors.initials: YS
authors.lastname: Shiau
authors.affiliation: Preventive Medicine Foundation, Taipei, Taiwan.
authors.forename: Szu-Hui
authors.initials: SH
authors.lastname: Chiang
authors.affiliation: Taipei Institute of Pathology, Taipei, Taiwan.
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Ho
authors.affiliation: Department of Health, Taipei City Government, Taipei, Taiwan.
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Liu
authors.affiliation: Department of Health, Taipei City Government, Taipei, Taiwan.
authors.forename: Yuan-Fang
authors.initials: YF
authors.lastname: Chung
authors.affiliation: Department of Health, Taipei City Government, Taipei, Taiwan.
authors.forename: Li-Ju
authors.initials: LJ
authors.lastname: Lin
authors.affiliation: MacKay Children's Hospital, Taipei, Taiwan.
authors.forename: Ming-Ren
authors.initials: MR
authors.lastname: Chen
authors.affiliation: Pediatrics Department, Cheng Hsin General Hospital, Taipei, Taiwan.
authors.forename: Jia-Kan
authors.initials: JK
authors.lastname: Chang
authors.affiliation: Division of General Pediatrics, Pediatrics Department, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Wen-Jue
authors.initials: WJ
authors.lastname: Soong
authors.affiliation: Department of Health, Taipei City Government, Taipei, Taiwan.
authors.forename: Hsiu-Lian
authors.initials: HL
authors.lastname: Lin
authors.affiliation: Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan.|Cardiac Medical Center, Tung's Taichung Metroharbor Hospital, Taichung, Taiwan.
authors.forename: Betau
authors.initials: B
authors.lastname: Hwang
authors.affiliation: Preventive Medicine Foundation, Taipei, Taiwan.|Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Kwang-Jen
authors.initials: KJ
authors.lastname: Hsiao
mesh_terms: D042241:Early Diagnosis; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000379:methods*; D010092:Oximetry / Q000379:methods; D012720:Severity of Illness Index; D013624:Taiwan