In this issue of The Journal, Mitchell and his associates (p 2348) report their results in the screening of nearly 130,000 neonates for congenital hypothyroidism by measuring thyroxine concentration in capillary blood samples collected on filter paper as the initial screening tool and by confirmatory testing with determinations of thyroid-stimulating hormone (TSH). Considering the disastrous consequences and relative frequency of this condition and the potentially beneficial effects of early recognition and treatment, a widely applicable screening test for hypothyroidism in the neonate is a welcome addition, indeed. Whereas it may be argued that the particular method used in this screening has the disadvantage of an unduly high false-positive rate and an unknown (but probably low) false-negative rate, there is no doubt that it was successful in detecting the disorder in at least 19 infants whose diagnosis and treatment almost certainly would have been delayed, with untold cost in both human
Nusynowitz ML. Fine Screening. JAMA. 1978;239(22):2373. doi:10.1001/jama.1978.03280490057028
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