Determining the TSH reference range in national newborn screening program for congenital hypothyroidism.
Autor: Dorreh, Fatemeh; Chehrei, Ali; Rafiei, Fatemeh; Talaei, Afsaneh; Rezvanfar, Mohammadreza; Almasi-Hashiani, Amir
Publication year: 2020
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
issn:1476-4954
doi: 10.1080/14767058.2019.1570122
Abstract:
Objective: Since the initiation of the thyroid screening program in Iran in 2005, 5 mIU/L has been selected as the threshold for thyroid stimulating hormone (TSH) for screening for congenital hypothyroidism. Given the specific disease pattern in the region and current controversies of the TSH cutoff point, a new cutoff point has been proposed in this study.Methods: This study was conducted on the existing database of the screening program consisting of 127,112 neonates in Markazi Province, center of Iran, during 2006-2012. Data on 614 referred neonates consisting of 414 neonates diagnosed of having hypothyroidism and 200 screened healthy neonates, were analyzed. The heel prick test had been done on the studied neonates to determine the TSH levels. The receiver-operator characteristic (ROC) curve and diagnostic values were used for data analysis.Results: The 5-mIU/L cutoff point in the study had a sensitivity and specificity and AUC of 86.5, 10 and 47%, respectively. Among the eleven selected cutoff points, 6.5 mIU/L had the appropriate sensitivity, specificity and AUC (58.9, 56.5 and 57%, respectively), negative and positive likelihood ratios (0.73 and 1.35, respectively).Conclusion: Given the very low specificity of the 5-mIU/L cutoff point for referral and with respect to the high rate of referrals and many false positive cases, we suggest to use the 6.5-mIU/L cutoff point which is more suitable.
Language: eng
Rights:
Pmid: 30700177
Tags: Humans; Infant, Newborn; Iran; Iran/epidemiology; Reference Values; threshold; Congenital hypothyroidism; ROC curve; *Congenital Hypothyroidism/diagnosis/epidemiology; neonatal screening; Neonatal Screening; thyroid stimulating hormone; Thyrotropin
Link: https://pubmed.ncbi.nlm.nih.gov/30700177/
