Newborn Screening - Disease Qualification

Disease Qualification

Newborn screening programs initially used screening criteria based largely on criteria established by JMG Wilson and F. Jungner in 1968. Although not specifically about newborn population screening programs, their publication, Principles and practice of screening for disease proposed ten criteria that screening programs should meet before being used as a public health measure. Newborn screening programs are administered in each jurisdiction, with additions and removals from the panel typically reviewed by a panel of experts. The four criteria from the publication that were relied upon when making decisions for early newborn screening programs were:

1. having an acceptable treatment protocol in place that changes the outcome for patients diagnosed early with the disease
2. an understanding of the condition's natural history
3. an understanding about who will be treated as a patient
4. a NBS screening test that is reliable for both affected and unaffected patients and is acceptable to the public

As diagnostic techniques have progressed, debates have arisen as to how screening programs should adapt. Tandem mass spectrometry has greatly expanded the potential number of diseases that can be detected, even without satisfying all of the other criteria used for making screening decisions. Duchenne muscular dystrophy is a disease that has been added to screening programs in several jurisdictions around the world, despite the lack of evidence as to whether early detection improves the clinical outcome for a patient.