Abstract
Screening for critical congenital heart disease (CCHD) in newborns based on a 2009 Swedish study has become the standard of care despite the complexity of the algorithm. A simplified algorithm which might increase the false-positive rate was proposed in 2020 but not formally endorsed by the American Academy of Pediatrics. We sought to determine how the current protocol and the proposed changes are perceived by clinicians. We performed an anonymous survey of professionals involved in the care of newborns regarding their perception of the current and proposed CCHD screening algorithms. 335 responses were evaluated. Less than 2% of respondents were dissatisfied with the existing screening algorithm or felt it was difficult to perform. 47% endorsed and 12% opposed the adoption of the proposed modifications with those most familiar with the proposed changes more likely to endorse them. Although many providers would accept a higher false-positive rate in CCHD screening, those who would have to transfer a baby from the birth site for assessment after a failed CCHD screening were less tolerant of an increased false-positive rate. Although the existing CCHD screening mechanisms appear to be very well received, the proposed changes to the CCHD algorithm were viewed positively by many respondents. Changes in this algorithm would likely be better tolerated in those setting where the consequences of a failed CCHD screening are more easily addressed.
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Acknowledgements
We would like to thank the members of the Wisconsin Guild of Midwives, Wisconsin Association for Perinatal Care, Wisconsin Chapter of the AAP, Association of Women’s Health, Obstetric and Neonatal Nurses, AAP section on Cardiology and Cardiac Surgery and the online Pediheart community for participating in this project.
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All authors contributed to the study conception and design. JCW and JSH wrote and distributed the survey. XZ supervised JCW in data analysis. JCW wrote the first draft of this manuscript with subsequent contributions by XZ and JSH.
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There are no prior publications with any overlapping information, although the results of this project were presented in poster form at the 2021 Midwest Pediatric Cardiology Society Annual Meeting and the 2021 AAP Section on Cardiology and Cardiac Surgery meeting.
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Walters, J.C., Zhang, X. & Hokanson, J.S. Providers’ Attitudes to Proposed Changes in the Critical Congenital Heart Disease Screening Algorithm. Pediatr Cardiol 43, 1354–1358 (2022). https://doi.org/10.1007/s00246-022-02858-4
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DOI: https://doi.org/10.1007/s00246-022-02858-4