Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026
[Impact of optimizing the quality control system on newborn screening outcomes for congenital hypothyroidism].
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Wang Jue, Qi Zhi-Ye, Zhong Qing-Hua, Jiang Yu-Hui, Wang Qiong, Zhao Xiao-Long, Duan Jiang
Аннотация
OBJECTIVES: To evaluate the impact of an optimized quality control system on neonatal screening outcomes for congenital hypothyroidism (CH).
METHODS: Screening data from 2013 to 2023 were retrospectively collected. Quality indicators were compared between the pre-optimization period (2013-2018) and the post-optimization period (2019-2023). The relationship between initial thyroid-stimulating hormone (TSH) screening values and positive predictive value (PPV) was examined.
RESULTS: A total of 1 264 541 neonates were screened, with a screening rate of 90.23%. The recall rate for initially positive cases was 94.87%, and the loss-to-follow-up rate was 5.13%. CH was confirmed in 419 infants, yielding a detection rate of 0.33‰ and a PPV of 3.60%. The median age at treatment initiation was 32 days. Compared with the pre-optimization period, the post-optimization period showed higher recall rate for initial positives, higher positivity among recalled cases, and higher CH detection rate, alongside a lower loss-to-follow-up rate; the age at treatment initiation was also reduced (all P<0.05). Neonates with initial TSH values ≥20.0 mIU/L had a PPV of 57.82%, significantly higher than those with TSH <20.0 mIU/L (P<0.001).
CONCLUSIONS: Optimizing the quality control system improves the quality of neonatal CH screening. Prioritizing the recall of neonates with initial TSH values ≥20.0 mIU/L may contribute to better prognosis.
METHODS: Screening data from 2013 to 2023 were retrospectively collected. Quality indicators were compared between the pre-optimization period (2013-2018) and the post-optimization period (2019-2023). The relationship between initial thyroid-stimulating hormone (TSH) screening values and positive predictive value (PPV) was examined.
RESULTS: A total of 1 264 541 neonates were screened, with a screening rate of 90.23%. The recall rate for initially positive cases was 94.87%, and the loss-to-follow-up rate was 5.13%. CH was confirmed in 419 infants, yielding a detection rate of 0.33‰ and a PPV of 3.60%. The median age at treatment initiation was 32 days. Compared with the pre-optimization period, the post-optimization period showed higher recall rate for initial positives, higher positivity among recalled cases, and higher CH detection rate, alongside a lower loss-to-follow-up rate; the age at treatment initiation was also reduced (all P<0.05). Neonates with initial TSH values ≥20.0 mIU/L had a PPV of 57.82%, significantly higher than those with TSH <20.0 mIU/L (P<0.001).
CONCLUSIONS: Optimizing the quality control system improves the quality of neonatal CH screening. Prioritizing the recall of neonates with initial TSH values ≥20.0 mIU/L may contribute to better prognosis.