Noting that the U.S. Food and Drug Administration is establishing standards for the machines that do pulse oximetry screenings, the working group recommended that CHD screenings use only those machines that conform to FDA standards when established.
To reduce the risk of false positive results on the first day of life, screening should be done on day two, the experts said. And the right hand and one foot (simultaneously or one after the other) should be the target test sites.
The committee also set optimal screening thresholds based on recent research from Sweden and England, which aim to reduce the risk for missing CHD or triggering a false positive.
To minimize stress on the child and family, facilities also should draft clear follow-up plans to ensure the swift and orderly handling of all babies who test positive for CHD, the group said.
"This is pretty good news," said Kemper. "But clearly there are still issues that need to be clarified before most hospitals would start doing this. The first is that if the screening picks up indications of a heart defect then the next step is the baby will need to get an echocardiogram, which is a scan of the heart. And a lot of hospitals just don't have that equipment. So some babies will need to be transferred to other hospitals for that."
Also, "we need to mitigate against the risk for false positives by having an effective algorithm in place to ensure that we're limiting the risk for incorrectly identifying defects," he added.
Dr. Alan R. Fleischman, medical director for the March of Dimes Foundation in White Plains, N.Y., and a working group participant, expressed enthusiasm for the screening guidelines.
"The seven specific types of heart disease this screening looks for account for somewhere around just a qua
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