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Should all newborns get the same tests?

Great disparities exist among state-run screening programs. Some think it may be time for national standards.

By Victoria Stagg Elliott, amednews staff. Feb. 4, 2002.

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California is launching a pilot program to expand its newborn screening program from four medical conditions to 30. Florida, which already screens for five metabolic diseases, is debating becoming the first state to screen for genetic predisposition to type 1 diabetes. And Wisconsin, which currently screens for 21 disorders, is running a pilot program to determine the feasibility of screening for five more.

These examples are evidence of the current patchwork policy applied to newborn screening. Diseases for which a newborn is tested are often determined by state-specific policies.

But with an increasing number of tests available and concerns about children who might slip through the cracks, government agencies, medical societies and patient advocacy groups are debating if a national screening program or national screening recommendations should be created.

"The states have done a very good job on their own of developing reliable screening procedures, and sometimes there's an advantage to having something worked on independently by 50 different states," said H.E. Wiltse, MD, PhD, professor of pediatrics with the University of Nebraska Medical Center in Omaha. "We might lose something if we go with uniform standards, but it may be time to do things differently."

The March of Dimes advocates a core of 10 tests. Meanwhile, the Dept. of Health and Human Services Maternal and Child Health Bureau has formed a working group to develop a list of conditions for which all infants should be screened and national standards for any additional tests. Their recommendations are expected within the next 18 months. [...]