An Optimal Capillary Screen Cut-off of Thyroid Stimulating Hormone for Diagnosing Congenital Hypothyroidism: Data from a Pilot Newborn Screening Program in Delhi
Objective To determine an appropriate cut-off of capillary Thyroid stimulating hormone (TSH) for congenital hypothyroidism. Study design Cross-sectional. Participants 174,000 neonates born in different hospitals of Delhi, India, from November 2014 to October 2016. Main outcome measures Correlation b...
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| Veröffentlicht in: | Indian pediatrics 2019-04, Vol.56 (4), p.281-286 |
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| creator | Verma, Prashant Kapoor, Seema Kalaivani, Mani Vats, Pallavi Yadav, Sangeeta Jain, Vandana Thelma, B. K. |
| description | Objective
To determine an appropriate cut-off of capillary Thyroid stimulating hormone (TSH) for congenital hypothyroidism.
Study design
Cross-sectional.
Participants
174,000 neonates born in different hospitals of Delhi, India, from November 2014 to October 2016.
Main outcome measures
Correlation between initial and repeat capillary TSH level and subsequent venous free thyroxine (fT4) level.
Results
102 newborns with initial/repeat capillary TSH level of ≥20 mIU/L (n=174) were confirmed to have congenital hypothyroidism at mean (SD) age of 5 (4) days. A good correlation between capillary TSH level and confirmatory venous fT4 level and postnatal age of sampling was obtained (r -0.6, -0.4). The area under the ROC curve (AUC) was 0.81 (95%CI 0.75 to 0.88), indicating referral capillary TSH level of 20 mIU/L to be a good predictor of subsequent high venous TSH level.
Conclusion
A cut off of ≥20 mIU/L for capillary TSH screening beyond 24 hours of life is optimal in the Indian setting for deciding further recall and workup, keeping a balance between sensitivity and recall rate. |
| doi_str_mv | 10.1007/s13312-019-1515-5 |
| format | Article |
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To determine an appropriate cut-off of capillary Thyroid stimulating hormone (TSH) for congenital hypothyroidism.
Study design
Cross-sectional.
Participants
174,000 neonates born in different hospitals of Delhi, India, from November 2014 to October 2016.
Main outcome measures
Correlation between initial and repeat capillary TSH level and subsequent venous free thyroxine (fT4) level.
Results
102 newborns with initial/repeat capillary TSH level of ≥20 mIU/L (n=174) were confirmed to have congenital hypothyroidism at mean (SD) age of 5 (4) days. A good correlation between capillary TSH level and confirmatory venous fT4 level and postnatal age of sampling was obtained (r -0.6, -0.4). The area under the ROC curve (AUC) was 0.81 (95%CI 0.75 to 0.88), indicating referral capillary TSH level of 20 mIU/L to be a good predictor of subsequent high venous TSH level.
Conclusion
A cut off of ≥20 mIU/L for capillary TSH screening beyond 24 hours of life is optimal in the Indian setting for deciding further recall and workup, keeping a balance between sensitivity and recall rate.</description><identifier>ISSN: 0019-6061</identifier><identifier>EISSN: 0974-7559</identifier><identifier>DOI: 10.1007/s13312-019-1515-5</identifier><identifier>PMID: 31064895</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Congenital Hypothyroidism - blood ; Congenital Hypothyroidism - diagnosis ; Dried Blood Spot Testing ; Humans ; India ; Infant, Newborn ; Maternal and Child Health ; Medicine ; Medicine & Public Health ; Neonatal Screening - methods ; Neonatal Screening - standards ; Pediatric Surgery ; Pediatrics ; Reference Values ; Research Paper ; ROC Curve ; Thyrotropin - blood</subject><ispartof>Indian pediatrics, 2019-04, Vol.56 (4), p.281-286</ispartof><rights>Indian Academy of Pediatrics 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c344t-fc35a81da0d30b05b285ddaef890c6ebf7a19f388dfa7427e84f810c326ad5513</citedby><cites>FETCH-LOGICAL-c344t-fc35a81da0d30b05b285ddaef890c6ebf7a19f388dfa7427e84f810c326ad5513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s13312-019-1515-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s13312-019-1515-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31064895$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Verma, Prashant</creatorcontrib><creatorcontrib>Kapoor, Seema</creatorcontrib><creatorcontrib>Kalaivani, Mani</creatorcontrib><creatorcontrib>Vats, Pallavi</creatorcontrib><creatorcontrib>Yadav, Sangeeta</creatorcontrib><creatorcontrib>Jain, Vandana</creatorcontrib><creatorcontrib>Thelma, B. K.</creatorcontrib><creatorcontrib>Science and Engineering Research Board – Newborn Screening Initiative Group (SERB-NBS) members</creatorcontrib><creatorcontrib>SERB-NBS Initiative Group</creatorcontrib><title>An Optimal Capillary Screen Cut-off of Thyroid Stimulating Hormone for Diagnosing Congenital Hypothyroidism: Data from a Pilot Newborn Screening Program in Delhi</title><title>Indian pediatrics</title><addtitle>Indian Pediatr</addtitle><addtitle>Indian Pediatr</addtitle><description>Objective
To determine an appropriate cut-off of capillary Thyroid stimulating hormone (TSH) for congenital hypothyroidism.
Study design
Cross-sectional.
Participants
174,000 neonates born in different hospitals of Delhi, India, from November 2014 to October 2016.
Main outcome measures
Correlation between initial and repeat capillary TSH level and subsequent venous free thyroxine (fT4) level.
Results
102 newborns with initial/repeat capillary TSH level of ≥20 mIU/L (n=174) were confirmed to have congenital hypothyroidism at mean (SD) age of 5 (4) days. A good correlation between capillary TSH level and confirmatory venous fT4 level and postnatal age of sampling was obtained (r -0.6, -0.4). The area under the ROC curve (AUC) was 0.81 (95%CI 0.75 to 0.88), indicating referral capillary TSH level of 20 mIU/L to be a good predictor of subsequent high venous TSH level.
Conclusion
A cut off of ≥20 mIU/L for capillary TSH screening beyond 24 hours of life is optimal in the Indian setting for deciding further recall and workup, keeping a balance between sensitivity and recall rate.</description><subject>Congenital Hypothyroidism - blood</subject><subject>Congenital Hypothyroidism - diagnosis</subject><subject>Dried Blood Spot Testing</subject><subject>Humans</subject><subject>India</subject><subject>Infant, Newborn</subject><subject>Maternal and Child Health</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neonatal Screening - methods</subject><subject>Neonatal Screening - standards</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Reference Values</subject><subject>Research Paper</subject><subject>ROC Curve</subject><subject>Thyrotropin - blood</subject><issn>0019-6061</issn><issn>0974-7559</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhS0EoqX0AdggL9kE_BMnDrsqAwxS1VZqu7acxJ66SnyD7QjN4_CmdZSBJStbvt85Vz4HoQ-UfKaE1F8i5ZyygtCmoIKKQrxC56Spy6IWonmd7-ukIhU9Q-9ifCaEcSboW3TGKalK2Yhz9OfK49s5uUmPuNWzG0cdjvi-D8Z43C6pAGsxWPzwdAzgBnyf0WXUyfkD3kOYwBtsIeCd0wcPcX1uwR-Mdyk77o8zpE3p4vQV73TS2AaYsMZ3boSEb8zvDoI_bVzldwEOQU_Yebwz45N7j95YPUZzeTov0OP3bw_tvri-_fGzvbouel6WqbA9F1rSQZOBk46IjkkxDNpY2ZC-Mp2tNW0sl3Kwui5ZbWRpJSU9Z5UehKD8An3afOcAvxYTk5pc7E0OxBtYomKMU9lwweuM0g3tA8QYjFVzyAmGo6JErc2orRmV81drM0pkzceT_dJNZvin-FtFBtgGxDzKCQb1DEvw-cv_cX0BRZebqQ</recordid><startdate>20190401</startdate><enddate>20190401</enddate><creator>Verma, Prashant</creator><creator>Kapoor, Seema</creator><creator>Kalaivani, Mani</creator><creator>Vats, Pallavi</creator><creator>Yadav, Sangeeta</creator><creator>Jain, Vandana</creator><creator>Thelma, B. K.</creator><general>Springer India</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20190401</creationdate><title>An Optimal Capillary Screen Cut-off of Thyroid Stimulating Hormone for Diagnosing Congenital Hypothyroidism: Data from a Pilot Newborn Screening Program in Delhi</title><author>Verma, Prashant ; Kapoor, Seema ; Kalaivani, Mani ; Vats, Pallavi ; Yadav, Sangeeta ; Jain, Vandana ; Thelma, B. K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c344t-fc35a81da0d30b05b285ddaef890c6ebf7a19f388dfa7427e84f810c326ad5513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Congenital Hypothyroidism - blood</topic><topic>Congenital Hypothyroidism - diagnosis</topic><topic>Dried Blood Spot Testing</topic><topic>Humans</topic><topic>India</topic><topic>Infant, Newborn</topic><topic>Maternal and Child Health</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neonatal Screening - methods</topic><topic>Neonatal Screening - standards</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Reference Values</topic><topic>Research Paper</topic><topic>ROC Curve</topic><topic>Thyrotropin - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Verma, Prashant</creatorcontrib><creatorcontrib>Kapoor, Seema</creatorcontrib><creatorcontrib>Kalaivani, Mani</creatorcontrib><creatorcontrib>Vats, Pallavi</creatorcontrib><creatorcontrib>Yadav, Sangeeta</creatorcontrib><creatorcontrib>Jain, Vandana</creatorcontrib><creatorcontrib>Thelma, B. K.</creatorcontrib><creatorcontrib>Science and Engineering Research Board – Newborn Screening Initiative Group (SERB-NBS) members</creatorcontrib><creatorcontrib>SERB-NBS Initiative Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Indian pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Verma, Prashant</au><au>Kapoor, Seema</au><au>Kalaivani, Mani</au><au>Vats, Pallavi</au><au>Yadav, Sangeeta</au><au>Jain, Vandana</au><au>Thelma, B. K.</au><aucorp>Science and Engineering Research Board – Newborn Screening Initiative Group (SERB-NBS) members</aucorp><aucorp>SERB-NBS Initiative Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An Optimal Capillary Screen Cut-off of Thyroid Stimulating Hormone for Diagnosing Congenital Hypothyroidism: Data from a Pilot Newborn Screening Program in Delhi</atitle><jtitle>Indian pediatrics</jtitle><stitle>Indian Pediatr</stitle><addtitle>Indian Pediatr</addtitle><date>2019-04-01</date><risdate>2019</risdate><volume>56</volume><issue>4</issue><spage>281</spage><epage>286</epage><pages>281-286</pages><issn>0019-6061</issn><eissn>0974-7559</eissn><abstract>Objective
To determine an appropriate cut-off of capillary Thyroid stimulating hormone (TSH) for congenital hypothyroidism.
Study design
Cross-sectional.
Participants
174,000 neonates born in different hospitals of Delhi, India, from November 2014 to October 2016.
Main outcome measures
Correlation between initial and repeat capillary TSH level and subsequent venous free thyroxine (fT4) level.
Results
102 newborns with initial/repeat capillary TSH level of ≥20 mIU/L (n=174) were confirmed to have congenital hypothyroidism at mean (SD) age of 5 (4) days. A good correlation between capillary TSH level and confirmatory venous fT4 level and postnatal age of sampling was obtained (r -0.6, -0.4). The area under the ROC curve (AUC) was 0.81 (95%CI 0.75 to 0.88), indicating referral capillary TSH level of 20 mIU/L to be a good predictor of subsequent high venous TSH level.
Conclusion
A cut off of ≥20 mIU/L for capillary TSH screening beyond 24 hours of life is optimal in the Indian setting for deciding further recall and workup, keeping a balance between sensitivity and recall rate.</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>31064895</pmid><doi>10.1007/s13312-019-1515-5</doi><tpages>6</tpages></addata></record> |
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| ispartof | Indian pediatrics, 2019-04, Vol.56 (4), p.281-286 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Congenital Hypothyroidism - blood Congenital Hypothyroidism - diagnosis Dried Blood Spot Testing Humans India Infant, Newborn Maternal and Child Health Medicine Medicine & Public Health Neonatal Screening - methods Neonatal Screening - standards Pediatric Surgery Pediatrics Reference Values Research Paper ROC Curve Thyrotropin - blood |
| title | An Optimal Capillary Screen Cut-off of Thyroid Stimulating Hormone for Diagnosing Congenital Hypothyroidism: Data from a Pilot Newborn Screening Program in Delhi |
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