Background: Screening for congenital hypothyroidism (CH) has virtually eradicated the severe mental handicap associated with late or absent treatment. We have previously reported two audits of newborn screening for CH between 1979 and 2003 showing significant improvement from the first to more recent period.
Objective and hypotheses: We aimed to audit the period 20042013 and report trends in timing of sampling, laboratory processing, delay between first and subsequent sample, notification of abnormal results and replacement therapy initiation. We hypothesise that sample timing is similar but it is taking longer for samples to reach the laboratory ameliorated by more rapid laboratory processing.
Method: All data was extracted from the national CH database. Patients consisted of those who were referred after one abnormal result (TSH >25 mIU/l) or those who required a second sample. Processing of data was carried out using Minitab 15.1. KruskalWallis and MannWhitney U tests were used to compare data between years.
Results: Median (range) time to first sample, receipt by laboratory, notification of abnormal result and start of treatment were 5 (112), 8 (413), 10 (517), and 11 (124) days of life respectively. Sampling was significantly slower in 2004. Laboratory receipt occurred on day 9 in 2004 and 2006, improved to day 7 for 2005 and 20072008 and 2010 but worsened to day 8 in 20112013 and day 8.5 in 2009. Notification delay reflects slow laboratory receipt (2004, 2006, and 2009 being the slowest). Treatment start was also slowest in these 3 years with the median being 12.5 days in 2004. However in recent years this has improved to day 10 in 2012 and day 9 in 2013.The median (range) delay in obtaining a second screening sample was 9 (255) days but has improved by 2 days compared to the last audit period.
Conclusion: Despite a recent worsening in the day of receipt by the laboratory, start of treatment continues to get earlier, suggesting that the laboratory has indeed improved processing time for samples. It is heartening that the delay between first and second samples has improved in this audit period.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology