Taylor-Phillips, Sian, Stinton, Chris, Ferrante di Ruffano, Lavinia, Seedat, Farah, Clarke, Aileen and Deeks, Jonathan J. (2018) Association between use of systematic reviews and national policy recommendations on screening newborn babies for rare diseases : systematic review and meta-analysis. British Medical Journal, 361 . k1612. doi:10.1136/bmj.k1612 ISSN 0959-8146.

Preview	PDF WRAP-association-between-use-systematic-reviews-national-policy-recommendations-Taylor-Phillips-2018.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (813Kb) | Preview
	PDF WRAP-association-systematic-policy-screening-babies-diseases-Stinton-2018.pdf - Accepted Version Embargoed item. Restricted access to Repository staff only - Requires a PDF viewer. Download (565Kb)

Request Changes to record.

Abstract

Objective

To understand whether international differences in recommendations of whether to screen for rare diseases using the newborn blood spot test might in part be explained by use of systematic review methods.

Design

Systematic review and meta-analysis.

Data sources

Website searches of 26 national screening organisations.

Eligibility criteria for study selection

Journal articles, papers, legal documents, presentations, conference abstracts, or reports relating to a national recommendation on whether to screen for any condition using the newborn blood spot test, with no restrictions on date or language.

Data extraction

Two reviewers independently assessed whether the recommendation for or against screening included systematic reviews, and data on test accuracy, benefits of early detection, and potential harms of overdiagnosis.

Analysis

The odds of recommending screening according to the use of systematic review methods was estimated across conditions using meta-analysis.

Results

93 reports were included that assessed 104 conditions across 14 countries, totalling 276 recommendations (units of analysis). Screening was favoured in 159 (58%) recommendations, not favoured in 98 (36%), and not recommended either way in 19 (7%). Only 60 (22%) of the recommendations included a systematic review. Use of a systematic review was associated with a reduced probability of screening being recommended (23/60 (38%) v 136/216 (63%), odds ratio 0.17, 95% confidence interval 0.07 to 0.43). Of the recommendations, evidence for test accuracy, benefits of early detection, and overdiagnosis was not considered in 115 (42%), 83 (30%), and 211 (76%), respectively.

Conclusions

Using systematic review methods is associated with a reduced probability of screening being recommended. Many national policy reviews of screening for rare conditions using the newborn blood spot test do not assess the evidence on the key benefits and harms of screening.

Item Type:	Journal Article
Alternative Title:
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Blood -- Analysis, Infants -- Diseases -- Diagnosis, Medical screening, Systematic reviews (Medical research)
Journal or Publication Title:	British Medical Journal
Publisher:	BMJ Group
ISSN:	0959-8146
Official Date:	9 May 2018
Dates:	Date Event 9 May 2018 Published 16 March 2018 Accepted
Volume:	361
Article Number:	k1612
DOI:	10.1136/bmj.k1612
Status:	Not Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	4 May 2018
Date of first compliant Open Access:	11 May 2018
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID UNSPECIFIED National Institute for Health Research http://dx.doi.org/10.13039/501100000272
Related URLs:	Publisher

Request changes or add full text files to a record

Repository staff actions (login required)

View Item

Downloads