Talk:Newborn screening

message: The above template was added without the promised discussion on the talk page. Please add discussion: newborn screening is carried out in nations with adequate health care systems, not those with inadequate health care systems, so your ideas on how to expand discussion of newborn screening to areas in which it is not carried out would be most enlightening. - Nunh-huh 02:13, 20 Oct 2004 (UTC)

message: Anonymous contributor changed text to:
"would anyone be reluctant to support the new, expanded screening programs? As the number of diseases included within the screening panel has increased, the cost to follow up potential positive cases has risen dramatically. If one assumes that state budgets for child health are constrained and finite, dollars spent on additional testing for false positive screen results exceed the costs saved by identifying a true positive cases and reduces resources available to other potentially lifesaving programs such as care for the uninsured or liability insurance for infant immunizations. The issue may be determined by juries deciding whether hospitals must routinely offer expanded newborn screening or risk multimillion dollar malpractice verdicts. Can another US$15-50 for each newborn infant be added to the cost of care or obtained from the state legislatures?"  The problem with this is that it makes claims that are more specific for the cost with no back up evidence. The fundamental problem is not an increasing cost for false positives, but our expanding capacity to detect ever rarer diseases. The math for a break-even program has to show that cost saved for hospital or institutional care prevented, and that person's potential productivity will pay for the costs of testing X thousand babies at Y dollars apiece (including of course dealing with false positives). The math is very favorable for the relatively common and fairly treatable diseases like hypothyroidism and galactosemia, but as the disease gets rarer, or the treatment gets less effective or more expensive, the math becomes a net cost. We can certainly advocate that our society privilege children with these diseases in a way that it does not for many more common diseases, but we at least need to examine both the economic and social justice issues openly before simply demanding it as a state service. Your changes focusing on false positives miss this important point. Also, I think the costs for extended testing already in the article are more accurate, but am open to evidence on all these points. Please become a named user and we can discuss it. alteripse 00:24, 30 May 2005 (UTC)
thread_title: reason for reversion

message: These issues are discussed in the AAP guideline, 2008, added to referrences with an on-line link. Pustelnik (talk) 18:38, 16 January 2008 (UTC)
thread_title: Cost-Benefit Analysis

message: I received a complaint on my talk page about the same issue Alteripse mentioned above. (I didn't author the content in question, but I did make the most recent change to the page, which presumably is why the anon contacted me.) I've looked at the paragraphs, and I agree that they seem unencylopedic. I've moved two paragraphs from the article to below, in case anybody wants to argue for their re-inclusion. --Arcadian 01:45, 5 January 2006 (UTC)
replies: text: I ask you to assume good faith. I didn't delete the content; I moved it to the talk page in case anybody wanted to discuss it. If you want to keep the content, it's no skin off my nose. But I do ask that you take care when you revert -- you changed more than you thought you did.  --Arcadian 02:47, 5 January 2006 (UTC)

text: We're not totally back to the December 9th version, but it's good enough, and I think we'll both agree that the one major change ("In the United States, there...") is an improvement. If you do want to take a look at the two paragraphs in question, my concerns (and presumably those of the anon) were with the rhetorical questions, the unsourced numbers, and the presumption of motivations. But I will refrain from further edits on that section (at least for the next year or so), and I'll defer the judgement of others to determine that content.   --Arcadian 04:14, 5 January 2006 (UTC)
thread_title: Paragraphs removed

message: From the anon who commented to Arcadian on 1/4/06 now User:Pleidies 
I read the exchange on this talk page and appreciate the discussion.  Please review the following draft and consider updating the section "Expanded Screening and Expanded Controversies."   (I have hard copy sources for both of the two California stats but could not find links to them online).  Comments, questions, edits and additional dicussion are welcome.
..................
Why would anyone be reluctant to support the new, expanded screening programs?  Instituting MS/MS screening often requires a sizable up front expenditure.  When States choose to run their own programs the initial costs for equipment, training and new staff can be significant.  The State of California required $15M in FY 2005 to fund its newborn screening expansion effort..  To avoid at least a portion of the up front costs, some states such as Mississippi have chosen to contract with private labs for expanded screening.  Others have chosen to form Regional Partnerships sharing both costs and resources.   But for many states, screening is already an integrated part of the department of health which can not be easily replaced.  Thus the initial expenditures can be difficult for states with tight budgets to justify in one fiscal year.  Screening fees have also increased in recent years as healthcare costs rise and more states add MS/MS screening to their programs. (See Report of Summation of Fees Charged for Newborn Screening, 2001 - 2005) Some argue that dollars spent for these programs may reduce resources available to other potentially lifesaving programs.  
However, recent studies suggest that expanded screening is cost effective in the long run (see ACMG report page 94-95 and articles published in Pediatrics here(p1406) and here).  Others sources such as Delaware’s Newborn Screening Program and California’s Senate Office of Research are convinced that expanded screening provides a net savings in healthcare costs.  Advocates are quick to point out studies such as these when trying to convince state legislatures to mandate expanded screening.
Expanded newborn screening is also causing controversy among some health care providers who worry about the availability of effective treatments, screening accuracy and issues of informed consent (see Financial, Ethical, Legal, and Social Issues)
The issue may ultimately be determined by juries deciding whether hospitals must routinely offer expanded newborn screening or risk multimillion dollar malpractice verdicts.
--Pleidies 07:38, 12 January 2006 (UTC)
replies: text: Hello -- I'm commenting not because I am an expert on this topic, but because Pleidies has requested several times that I weigh in (more details on why are available above.) First, I'd like to commend you on getting an account. People are much more willing to discuss things with people who have accounts, because they can be more confident that they are talking to is the same person they talked to before, which facilitates compromise. I do not know if User:alteripse objects to your proposed changes -- it does not appear that he responded to your inquiries. So my recommendation is that you read Wikipedia:Be bold in updating pages, and then start to make the updates yourself. Make sure you leave good edit summaries describing what you are doing. When you make the change, it will show up on his watchlist, and if he objects to your changes, you should know about it before too long. A couple more suggestions -- take a look at Wikipedia:Policies and guidelines before starting in earnest -- understanding the culture can help people avoid many missteps. And finally, you may want to consider making some edits on less controversial topics before editing this one. Usually when people make changes, the other people watching that page look at the recent contributions of the editor to try to determine if the changes were made in good faith. It is sort of like building up a credit record. Hopefully this is enough to get you started, but if you have any questions or troubles, let me know. --Arcadian 13:00, 12 January 2006 (UTC)

text: You missed my point. The charge for the extended tandem mass spec screening was about $23 when offered by Neogen to individual hospitals in the late 1990s. Nearly all hospitals in this state adopted it. When the state was at the point of mandating it, Pediatrix bought Neogen as an opportunity for profit and the price rose substantially for the same test. The price for individuals is now $89. While several factors changed and the two pricings are not wholly comparable, it added another issue that caused a further hesitation in adoption. This was the point when several states looked for other alternative sources of this test. alteripse 12:26, 24 January 2006 (UTC)

text: I think worth is a valid word, but change it for clarity not because someone is squeamish at recognizing that at the heart of the decision is a weighing of dollar cost against lifes saved or improved. alteripse 12:26, 24 January 2006 (UTC)
thread_title:  Suggested change to "Expanded Screening and Expanded Controversies" 

message: CYSTIC FIBROSIS: IN MOST STATES IN THE US, CF IS TESTED FOR ACCORDING TO THE LINK TO THE US NEWBORN SCREENING WEBSITE OFFERED BY THIS ARTICLE. IT SHOULD BE INCLUDED ON THIS PAGE. Heathermadisonline (talk) 13:20, 2 August 2009 (UTC)
replies: text: CF is already listed -- the first condition under miscellaneous multisystem diseases. What exactly are you suggesting? alteripse (talk) 20:21, 4 August 2009 (UTC)
thread_title: CF

message: Any reason to use the same image twice in the same article?  it looks a little silly. 
136.1.1.154 (talk) 21:38, 7 January 2010 (UTC)
thread_title:  Same Image Twice 

message: I am going to be reworking this article a bit, to try and focus on general newborn screening rather than the specifics of any given country.  If possible, differences between countries will be pulled out in the "Around the world" section.  If the article gets too large, newborn screening articles in a given country could be split off into a new article.  Any comments, suggestions or assistance are welcome.  Canada Hky (talk) 22:24, 27 May 2011 (UTC)
thread_title: Rewrite in progress

message: I have removed some of this, and worked on incorporating the rest.  Some of it was inaccurate - tandem mass spectrometry is not a "genomic sequencing" technology. Most of the first paragraph and the bulleted list were repeated from earlier in the article.  Canada Hky (talk) 01:08, 12 November 2013 (UTC)
thread_title: Bioethics section

message: I am not an expert in this area.  However the article states using heel-stick cards for TREC analysis is not available.  It is now being done in a number of states so this section should be edited.  — Preceding unsigned comment added by 68.175.2.93 (talk) 18:28, 8 March 2014 (UTC)
thread_title:  SCID screening 

message: Hello fellow Wikipedians,
I have just added archive links to  on Newborn screening. Please take a moment to review my edit. If necessary, add  after the link to keep me from modifying it. Alternatively, you can add  to keep me off the page altogether. I made the following changes:
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thread_title:  External links modified 

message: FYI http://www.usatoday.com/story/opinion/2016/12/22/newborn-tests-screening-hospitals-editorials-debates/95769812/ Ottawahitech (talk) 22:40, 23 December 2016 (UTC)
thread_title:  When a child is born, tests should be uniform: Our view 

message: The BabySeq project (whole genome sequencing,  2019) is missing. The first target whole genome screening in China on 128 diseases is missing. Screen4care EU project is missing.
Also the examination of exome sequencing for newborn screening is missing. 
Genomics England in the UK is missing and in Germany the project is called NEW_LIVES.
 Wuerzele (talk) 19:03, 20 March 2024 (UTC)
thread_title:  2024 Update needed