Real-time polymerase chain reaction tests versus antenatal culture tests for the screening of maternal group B Streptococcus colonisation in labour

Seedat, Farah; Cooper, Jennifer; Uthman, Olalekan A.; Takwoingi, Yemisi; Robinson, Esther; Kandala, Ngianga Bakwin; Stranges, Saverio; Taylor‐Phillips, Sian

doi:10.1002/14651858.cd013016

Cited by 4 publications

(6 citation statements)

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“…However, it may be challenging to quantify certain factors (eg increased stigma) and draw direct comparisons between the benefits and harms (eg reduced transmission versus false-positive results). Evaluating the potential benefits and harms of ACF may be even more challenging in low- and middle-income settings, as many do not have established processes for the development of screening policies in place [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

‘A double-edged sword’: Perceived benefits and harms of active case-finding for people with presumptive tuberculosis and communities—A qualitative study based on expert interviews

et al. 2021

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Background Active case-finding (ACF), also referred to as community-based tuberculosis screening, is a component of the World Health Organization’s End TB Strategy. ACF has potential benefits but also harms, which need to be carefully assessed when developing and implementing ACF policies. While empirical evidence on the benefits of ACF is still weak, evidence on the harms is even weaker. This study aimed to explore experts’ views on the benefits and harms of ACF for people with presumptive TB and communities. Methods This was an exploratory study. Semi-structured interviews were conducted with a purposive sample of 39 experts from international, non-governmental/non-profit organizations, funders, government institutions, international societies, think tanks, universities and research institutions worldwide. Framework analysis was applied. Results Findings elaborated perceived benefits of ACF, including reaching vulnerable populations, reducing patient costs, helping raise awareness for tuberculosis among individuals and engaging communities, and reducing tuberculosis transmission. Perceived harms included increasing stigma and discrimination, causing false-positive diagnoses, as well as triggering other unintended consequences related to screening for tuberculosis patients, such as deportation of migrants once confirmed to have tuberculosis. Most of the perceived benefits of ACF could be linked to its objective of finding and treating persons with tuberculosis early (theme 1), while ACF was also perceived as a “double-edged sword” and could cause harms, if inappropriately designed and implemented (theme 2). The analysis underlined the importance of considering the benefits and harms of ACF throughout the screening pathway. The study provides new insights into the perceived benefits and harms of ACF from the perspectives of experts in the field. Conclusion This study highlights gaps in the evidence base surrounding ACF and can stimulate further research, debate and analysis regarding the benefits and harms of ACF to inform contextual optimization of design and implementation of ACF strategies.

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Section: Discussionmentioning

confidence: 99%

‘A double-edged sword’: Perceived benefits and harms of active case-finding for people with presumptive tuberculosis and communities—A qualitative study based on expert interviews

et al. 2021

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“…As with the review by Seedat et al ( 14 ) of population-based screening criteria adopted across a number of countries, the findings of the workshop were more likely to focus on considerations relating to “the screening program” as opposed to the condition, test, and treatment. The issues identified in relation to the screening program were largely those that would be relevant to all screening programs, not only preconception expanded carrier screening.…”

Section: Discussionmentioning

confidence: 99%

“…While the Wilson and Jungner principles are the benchmark for government decision-making in screening, the ways in which they have been applied in practice vary across the globe. This is highlighted through a recent review of the criteria for deciding whether to introduce screening programs in Australia, Canada, Denmark, Finland, France, Germany, Italy, the Netherlands, New Zealand, Sweden, the UK, and the USA ( 14 ). Across these countries, Seedat et al ( 14 ) identified 46 unique criteria that were associated with screening in general, most of which related to the screening program (27) as opposed to the condition (7), test (6), and treatment (6).…”

Section: Introductionmentioning

confidence: 99%

“…This is highlighted through a recent review of the criteria for deciding whether to introduce screening programs in Australia, Canada, Denmark, Finland, France, Germany, Italy, the Netherlands, New Zealand, Sweden, the UK, and the USA ( 14 ). Across these countries, Seedat et al ( 14 ) identified 46 unique criteria that were associated with screening in general, most of which related to the screening program (27) as opposed to the condition (7), test (6), and treatment (6). Generally, the reason for expansion beyond the original Wilson and Jungner principles and variation in government decision-making criteria is to ensure processes sufficiently explore the issues most pertinent to each local setting ( 15 , 16 ).…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of an International Workshop on Preconception Expanded Carrier Screening: Some Considerations for Governments

Molster

Lister

Metternick-Jones

et al. 2017

Front. Public Health

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BackgroundConsideration of expanded carrier screening has become an emerging issue for governments. However, traditional criteria for decision-making regarding screening programs do not incorporate all the issues relevant to expanded carrier screening. Further, there is a lack of consistent guidance in the literature regarding the development of appropriate criteria for government assessment of expanded carrier screening. Given this, a workshop was held to identify key public policy issues related to preconception expanded carrier screening, which governments should consider when deciding whether to publicly fund such programs.MethodsIn June 2015, a satellite workshop was held at the European Society of Human Genetics Conference. It was structured around two design features: (1) the provision of information from a range of perspectives and (2) small group deliberations on the key issues that governments need to consider and the benefits, risks, and challenges of implementing publicly funded whole-population preconception carrier screening.ResultsForty-one international experts attended the workshop. The deliberations centered primarily on the conditions to be tested and the elements of the screening program itself. Participants expected only severe conditions to be screened but were concerned about the lack of a consensus definition of “severe.” Issues raised regarding the screening program included the purpose, benefits, harms, target population, program acceptability, components of a program, and economic evaluation. Participants also made arguments for consideration of the accuracy of screening tests.ConclusionA wide range of issues require careful consideration by governments that want to assess expanded carrier screening. Traditional criteria for government decision-making regarding screening programs are not a “best fit” for expanded carrier screening and new models of decision-making with appropriate criteria are required. There is a need to define what a “severe” condition is, to build evidence regarding the reliability and accuracy of screening tests, to consider the equitable availability and downstream effects on and costs of follow-up interventions for those identified as carriers, and to explore the ways in which the components of a screening program would be impacted by unique features of expanded carrier screening.

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“…Furthermore, the practical implementation of population screening creates further potential obstacles to establishing that the benefits thereof outweigh the harms, as the improper implementation thereof can negate the anticipated benefits [ 18 ]. Economic factors can also be relevant to the implementation of a population screening programme.…”

Section: Introductionmentioning

confidence: 99%

Of Screening, Stratification, and Scores

Knoppers

Bernier

Moreno

et al. 2021

JPM

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Technological innovations including risk-stratification algorithms and large databases of longitudinal population health data and genetic data are allowing us to develop a deeper understanding how individual behaviors, characteristics, and genetics are related to health risk. The clinical implementation of risk-stratified screening programmes that utilise risk scores to allocate patients into tiers of health risk is foreseeable in the future. Legal and ethical challenges associated with risk-stratified cancer care must, however, be addressed. Obtaining access to the rich health data that are required to perform risk-stratification, ensuring equitable access to risk-stratified care, ensuring that algorithms that perform risk-scoring are representative of human genetic diversity, and determining the appropriate follow-up to be provided to stratification participants to alert them to changes in their risk score are among the principal ethical and legal challenges. Accounting for the great burden that regulatory requirements could impose on access to risk-scoring technologies is another critical consideration.

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Real-time polymerase chain reaction tests versus antenatal culture tests for the screening of maternal group B Streptococcus colonisation in labour

Abstract: Sian (2018) Realtime polymerase chain reaction tests versus antenatal culture tests for the screening of maternal group B Streptococcus colonisation in labour. Cochrane Database of Systematic Reviews, 2018 (5). CD013016.

Cited by 4 publications

References 29 publications

‘A double-edged sword’: Perceived benefits and harms of active case-finding for people with presumptive tuberculosis and communities—A qualitative study based on expert interviews

‘A double-edged sword’: Perceived benefits and harms of active case-finding for people with presumptive tuberculosis and communities—A qualitative study based on expert interviews

Outcomes of an International Workshop on Preconception Expanded Carrier Screening: Some Considerations for Governments

Of Screening, Stratification, and Scores

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