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Related Experiment Videos

Evaluation of three thyroid-function screening tests for detecting neonatal hypothyroidism.

P G Walfish

    Lancet (London, England)
    |June 5, 1976
    PubMed
    Summary

    Thyroid-stimulating hormone (T.S.H.) screening of cord blood offers superior accuracy for diagnosing neonatal hypothyroidism compared to thyroxine (T4) tests. A combined approach, using T.S.H. as a primary screen and T4 for supplementary testing, minimizes false positives.

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    Molecular endocrinology (Baltimore, Md.)·2000

    Area of Science:

    • Endocrinology
    • Neonatal Screening
    • Diagnostic Test Evaluation

    Background:

    • Early diagnosis of neonatal hypothyroidism is crucial for preventing developmental issues.
    • Current screening methods using thyroxine (T4) levels in neonates and cord blood have limitations.
    • High false-positive rates in T4 screening lead to unnecessary follow-ups and increased healthcare costs.

    Purpose of the Study:

    • To evaluate three thyroid-function detection methods for routine neonatal hypothyroidism screening.
    • To compare the efficacy of dried capillary-blood T4, serum T4, and serum T.S.H. assays.
    • To identify the most accurate and efficient screening strategy for early diagnosis.

    Main Methods:

    • Evaluated dried capillary-blood T4 on filter-paper discs for 9734 neonates.

    Related Experiment Videos

  • Assessed serum T4 and thyroid-stimulating hormone (T.S.H.) from cord blood in 4911 and 3733 infants, respectively.
  • Implemented follow-up protocols for low T4 percentiles to manage false negatives.

    • Main Results:

    • Neonatal blood-T4 and cord serum-T4 screening resulted in a false-positive recall incidence exceeding 92%.
    • Factors like thyroxine-binding-globulin deficiency, prematurity, and maternal drug ingestion influenced T4 levels.
    • Cord T.S.H. assays demonstrated higher specificity and sensitivity for primary hypothyroidism, accurately identifying two affected cases.

    Conclusions:

    • Initial T4 screening tests lead to impractically high recall rates and false-positive incidences.
    • Cord T.S.H. screening is a more reliable method for diagnosing primary hypothyroidism in neonates.
    • Recommended strategy: Use T.S.H. as the primary screening test, with low T4 levels prompting supplementary T.S.H. testing to reduce follow-up recalls to <0.2%.