Pulse oximetry screening for congenital heart defects in newborn infants (PulseOx): a test accuracy study

Ewer, Andrew K; Middleton, LJ; Furmston, Alexandra; Bhoyar, Abhay; Daniels, Jane; Thangaratinam, Shakila; Deeks, Jonathan J; Khan, Khalid S.

doi:10.1016/s0140-6736(11)60753-8

Cited by 289 publications

(336 citation statements)

References 28 publications

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“…Andrew K Ewer et al screened more than 20,000 new born, and false position was 169 or (0.8%). In our study there were only 4 cases of false positive screen (3) . Frank Thomas Riede et al screened more than 40,000 babies and had 40 false-positive screen of which 12 were healthy, 15 had pulmonary hypertension of newborn and 13 had sepsis (4) .…”

Section: Discussioncontrasting

confidence: 49%

Screening Newborn babies for Congenital Heart Disease: Prospective Observational Study

Theranirajan¹

2017

JMSCR

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Section: Discussioncontrasting

confidence: 49%

Screening Newborn babies for Congenital Heart Disease: Prospective Observational Study

Theranirajan¹

2017

JMSCR

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“…None of the studies reviewed by the SACHDNC included receiver operator characteristic curves developed from primary data, which would allow a direct evaluation of this trade-off. However, on the basis of new data from the large population-based screening activities in Sweden 8 and England, 14 the work group developed a recommendation for screening that was based on what was shown to be effective in those studies.…”

Section: Screening Criteriamentioning

confidence: 99%

“…8,14 Repeated pulse-oximetry testing after an initial positive screen result if oxygen saturation is Ͻ95% in both extremities or there is a Ͼ3% absolute difference in oxygen saturation between the right hand and foot, as illustrated in the protocol, lowers the likelihood of a falsepositive result compared with a single measurement. However, there is no need to repeat pulse-oximetry testing if the oxygen saturation is Ͻ90% in any screen.…”

Section: Figurementioning

confidence: 99%

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Strategies for Implementing Screening for Critical Congenital Heart Disease

et al. 2011

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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.

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“…As a result, several investigators evaluated the use of routine pulse oximetry to identify infants with CCHD before discharge from delivery units and reported on its validity. 8,[11][12][13][14][15][16][17] In the United States, many state legislatures have mandated universal pulse oximetry screening of newborns, which was endorsed by the Secretary of Health and Human Services in 2011. The scientific committees of the American Academy of Pediatrics and the American Heart Association recommended that additional studies be conducted in large diverse populations across a broad range of delivery systems to determine whether pulse oximetry screening in neonates improves outcomes in infants with CCHD.…”

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confidence: 99%

Age at Referral and Mortality From Critical Congenital Heart Disease

Fixler

Nembhard

et al. 2014

Pediatrics

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BACKGROUND AND OBJECTIVE: Newborn pulse oximetry screening is recommended to promote early referral of neonates with critical congenital heart disease (CCHD) and reduce mortality; however, the impact of late referral on mortality is not well defined. The purpose of this population-based study was to describe the association between timing of referral to a cardiac center and mortality in 2360 liveborn neonates with CCHD. METHODS: Neonates with CCHD born before pulse oximetry screening (1996–2007) were selected from the Texas Birth Defects Registry and linked to state birth and death records. Age at referral was ascertained from date of first cardiac procedure at a cardiac center. Logistic and Cox proportional hazards regression models were used to estimate factors associated with late referral and mortality; the Kaplan-Meier method was used to estimate 3-month survival. RESULTS: Median age at referral was 1 day (25th–75th percentile: 0–6 days). Overall, 27.5% (649 of 2360) were referred after age 4 days and 7.5% (178 of 2360) had no record of referral. Neonatal mortality was 18.1% (277 of 1533) for those referred at 0 to 4 days of age, 9.0% (34 of 379) for those referred at 5 to 27 days of age, and 38.8% (69 of 178) for those with no referral. No improvement in age at referral was found across the 2 eras within 1996–2007. CONCLUSIONS: A significant proportion of neonates with CCHD experienced late or no referral to cardiac specialty centers, accounting for a significant number of the deaths. Future population-based studies are needed to determine the benefit of pulse oximetry screening on mortality and morbidity.

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Pulse oximetry screening for congenital heart defects in newborn infants (PulseOx): a test accuracy study

Cited by 289 publications

References 28 publications

Screening Newborn babies for Congenital Heart Disease: Prospective Observational Study

Screening Newborn babies for Congenital Heart Disease: Prospective Observational Study

Strategies for Implementing Screening for Critical Congenital Heart Disease

Age at Referral and Mortality From Critical Congenital Heart Disease

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