State health departments have been reluctant to adopt tandem mass spectrometry
for newborn screening because of its expense (start-up cost of about $400 0001) and doubts about its validity and utility. However,
pressure to adopt the screening technology has come from medicolegal proceedings
brought by parents of infants with genetic disorders who were not screened
and from the direct lobbying of hospitals and health departments by advocacy
groups (http://www.savebabies.org). In addition, a private screening
laboratory, Pediatrix Inc (formerly NeoGen Screening Inc), markets tandem
mass spectrometry to hospitals and states. Despite the continuing lack of
evidence regarding its safety and effectiveness, tandem mass spectrometry
is now mandated in 24 states (http://genes-r-us.uthscsa.edu).
Holtzman NA. Expanding Newborn Screening: How Good Is the Evidence? JAMA. 2003;290(19):2606–2608. doi:10.1001/jama.290.19.2606
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