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Use of Systematic Reviews Affects Newborn Screening Policy

TUESDAY, May 15, 2018 -- Use of systematic review methodology is associated with reduced likelihood of screening for rare diseases using the newborn blood spot test being recommended, according to a meta-analysis published online May 9 in The BMJ.

Sian Taylor-Phillips, Ph.D., from the University of Warwick in the United Kingdom, and colleagues conducted a systematic review and meta-analysis to examine the odds of recommending screening according to the use of systematic review methods across conditions. A total of 93 reports that assessed 104 conditions across 14 countries were included, totaling 276 recommendations.

The researchers found that screening was favored, not favored, and not recommended either way in 58, 36, and 7 percent of recommendations, respectively. A systematic review was included in only 22 percent of the recommendations. The probability of screening being recommended was reduced with use of a systematic review (38 versus 63 percent; odds ratio, 0.17). Evidence for test accuracy, benefits of early detection, and overdiagnosis was not considered in 42, 30, and 76 percent of the recommendations, respectively.

"Using systematic review methods is associated with a reduced probability of screening being recommended," the authors write. "Many national policy reviews of screening for rare conditions using the newborn blood spot test do not assess the evidence on the key benefits and harms of screening."

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Posted: May 2018