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A new algorithm DEtectS critical Congenital Heart Disease at different altitudes: ANDES-CHD study
Katia Bravo-Jaimes1, Tania Vasquez-Loarte2, Jose Rojas-Camayo3
1Department of Cardiovascular Medicine. Mayo Clinic, Jacksonville, FL, USA. bravo.katia@mayo.edu.
Summary
New algorithms for neonatal pulse oximetry screening (POS) can detect critical congenital heart disease (CCHD) at high altitudes. However, these new POS screening methods show high false positive rates, requiring further refinement for widespread use.
Area of Science:
- Pediatrics
- Cardiology
- Neonatology
Background:
- Neonatal pulse oximetry screening (POS) is crucial for detecting critical congenital heart disease (CCHD), reducing neonatal mortality.
- Current POS algorithms are ineffective at high altitudes, necessitating the development of new methods for these environments.
Purpose of the Study:
- To develop and evaluate new POS algorithms for CCHD detection in newborns at varying altitudes.
- To assess the performance of these algorithms in a high-altitude setting.
Main Methods:
- An observational, prospective study was conducted in Peru, enrolling newborns at altitudes ranging from 0 to 4380 meters.
- Two novel POS algorithms were designed using established cutoffs or percentile values (5th and 10th) for preductal and postductal oximetry.
- Newborns underwent oximetry and echocardiography, with follow-up to assess CCHD diagnosis.
Main Results:
- The study included 502 healthy newborns and 15 with CCHD.
- An algorithm using clinically accepted cutoffs demonstrated 92% sensitivity and 73% specificity.
- An algorithm using the 5th and 10th percentiles showed 80% sensitivity and 88% specificity, with a lower false positive rate (12%).
Conclusions:
- Two new algorithms show potential for detecting CCHD at high altitudes.
- Both algorithms exhibited adequate performance but were associated with high false positive rates, indicating a need for further optimization.
