Pilot Screening Program Research Articles

Population screening for congenital hypothyroidism.

A pilot screening programme for congenital hypothyroidism covering most of North London, Essex, Bedfordshire, and Hertfordshire entailed carrying out an assay of thyroid-stimulating hormone on single Guthrie dried blood spots. During one year 87 444 babies were screened and 26 cases of primary congenital hypothyroidism detected, giving an incidence of 1:3363. Only two cases (7.7%) had already been diagnosed on clinical grounds before the results of screening became available. In two other babies the diagnosis was delayed. The programme thus resulted in the early treatment of 22 babies, eight of whom already had pronounced features of hypothyroidism that had not been detected on routine clinical examinations. Although definitive evidence will not be available for some years, the results suggest that the prognosis for most of these babies is likely to be improved by early diagnosis; thus the introduction of national screening should be delayed no longer.

Moiré topography in scoliosis screening.

Moiré topography, a simple technique for three-dimensional quantitation, was used to provide interference fringe photographs of the human back with sufficient accuracy to be used for detecting children with asymmetry due to scoliosis. Experimental equipment, built and tested at the National Research Council of Canada, was used in a pilot screening program, involving 1100 children from the 10 to 12 year age group. Each child was examined clinically by the bending test and photographed by the moiré method. All subjects with positive bending tests, asymmetrical fringe patterns or both were submitted to radiographic examination and the results correlated. The moiré technique disclosed 94% of the cases which were found to be positive by X-ray examination, while the bending test disclosed only 46%. The percentages of false positive results were approximately the same for the 2 screening methods.

Adjunctive drug use by methadone patients.

Clinical impressions, reinforced by reports in both professional journals and the lay press, suggested that use and abuse of minor tranquilizers and sedative-hypnotics was extensive among patients in our drug treatment clinics and required some change in our policies. We surveyed a randomly selected national sample of methadone program physicians and found they shared our assumptions concerning the use of these drugs. A pilot program of urine screening for the presence of adjunctive drugs was completed, and we found the incidence of use to be below expected levels, except for opiates and alcohol. These results suggest we should reconsider plans to alter clinic policies concerning the regulation of these substances. A rigorous examination of serum and/or urine in a national research program to determine both the incidence of adjunctive drug use by clients in drug treatment programs and correlations of such data with national surveys would be an expensive undertaking, but would provide a more rational basis for policy making at both local and national levels.

Community medicine: screening for rubella on a university campus.

Today's college-age students have not benefited from the mass immunization of children that followed the introduction of live attenuated rubella vaccine in 1969. Speculation on one university campus as to the number of young women who were susceptible to rubella led to a pilot program of rubella screening and a follow-up program of immunization and provided valuable data on the need for such a project.

Serum thyrotropin and hypothyroidism during lithium therapy

High values for serum thyrotropin concentration were found in 12 cases of hypothyroidism during treatment of mano-depressive illness with lithium salts. A number of patients (334 patients) were then analyzed for serum thyrotropin and thyroxine in a pilot screening program for hypothyroidism during lithium therapy. High values for thyrotropin and low for thyroxine were found in two patients. Another six patients had clear, but less pronounced elevation of their serum thyrotropin concentrations; five of them had normal thyroxine concentrations. It is concluded that thyrotropin analysis may be useful to establish a diagnosis of so-called Li+-induced hypothyroidism. Screening of all lithium-treated patients for hypothyroidism by thyrotropin analysis, on the other hand, would hardly be rewarding.

Screening for thalassemia trait by electronic measurement of mean corpuscular volume.

THALASSEMIAS are a group of hereditary blood conditions with clinical and genetic implications that occur frequently in Mediterranean ethnic groups. There have been few attempts to screen high-prevalence populations for thalassemia trait in the United States, and a major deterrent has been the lack of a reliable, inexpensive screening method. The studies described below indicate that electronic determination of red-cell mean corpuscular volume is a valid screening test for thalassemia trait.A comprehensive pilot screening program for thalassemia trait was offered to members of two Greek Orthodox churches, and to families of persons known to have thalassemia; 300 subjects were . . .

Health Study of Adolescents Enrolled in the Neighborhood Youth Corps: Pilot Screening Program

Health Study of Adolescents Enrolled in the Neighborhood Youth Corps: Pilot Screening Program

SCREENING OF NEWBORN INFANTS FOR METABOLIC DISEASE

AN OPPORTUNITY to establish screening procedures for case-finding in a number of metabolic diseases now exists in the United States, because most infants are born in hospitals where appropriate screening can easily be carried out. Case-finding in the neonatal period facilitates early inauguration of therapy, genetic counseling, and improved understanding of the natural history and incidence of metabolic diseases. The Committee on Fetus and Newborn considered four types of screening programs: (1) screening of all newborn infants, (2) screening of specific groups of neonates with increased risk of certain disorders, (3) large scale, pilot-screening programs, designed primarily for research and acquisition of knowledge about the natural history of disease, (4) screening of expectant mothers, particularly using tests of amniotic fluid. The committee did not consider screening of older children. However, it is emphasized that a number of important diseases, e.g., Wilson's disease, cannot be detected by screening in the first few days of life. In evaluating screening tests for specific diseases, the Committee based its recommendations on the following criteria: 1. Does the seriousness of the disorder justify screening? 2. Is therapy for the disease in question available? 3. Is there a clearly identifiable segment of the population with an increased incidence of this disease? 4. Is it possible to perform reliable screening during the first few days of life? 5. Can the screening test be performed in a routine service laboratory? 6. Is the test acceptable to the physician and to a majority of parents? 7. Is the cost of the test acceptable?