Holder Pru, Clark Corinna C, Moody Louise, Boardman Felicity K, Cowlard Jacqui, Allen Lorna, Walter Claire, Bonham James R, Chudleigh Jane
Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London SE5 9PJ, UK.
Warwick Medical School, Warwick University, Coventry CV4 7AL, UK.
Int J Neonatal Screen. 2024 Feb 14;10(1):13. doi: 10.3390/ijns10010013.
The project aimed to gather, analyse, and compare the views of stakeholders about the proposed UK cystic fibrosis (CF) screening protocol incorporating next generation sequencing (NGS). The study design was based on principles of Q-methodology with a willingness-to-pay exercise. Participants were recruited from 12 CF centres in the UK. The study contained twenty-eight adults who have experience with CF (parents of children with CF ( = 21), including parents of children with CF transmembrane conductance regulator (CFTR)-related metabolic syndrome (CRMS)/CF screen positive-inconclusive diagnosis (CFSPID), an uncertain outcome ( = 3), and adults with CF ( = 4)), and nine health professionals involved in caring for children with CF. Parents and health professionals expressed a preference for a sensitive approach to NGS. This was influenced by the importance participants placed on not missing any children with CF via screening and the balance of harm between missing a case of CF compared to picking up more children with an uncertain outcome (CRMS/CFSPID). Given the preference for a sensitive approach, the need for adequate explanations about potential outcomes including uncertainty (CFSPID) at the time of screening was emphasized. More research is needed to inform definitive guidelines for managing children with an uncertain outcome following CF screening.
该项目旨在收集、分析和比较利益相关者对拟议的纳入下一代测序(NGS)的英国囊性纤维化(CF)筛查方案的看法。研究设计基于Q方法原则并进行了支付意愿调查。参与者从英国的12个CF中心招募。该研究包括28名有CF经历的成年人(CF患儿的父母(=21),包括患有CF跨膜传导调节因子(CFTR)相关代谢综合征(CRMS)/CF筛查阳性-诊断不确定(CFSPID)患儿的父母、结局不确定的父母(=3)以及成年CF患者(=4)),以及9名参与照顾CF患儿的卫生专业人员。父母和卫生专业人员表示倾向于采用敏感的NGS方法。这受到参与者对筛查时不漏诊任何CF患儿的重视程度以及漏诊CF病例与检出更多结局不确定的患儿(CRMS/CFSPID)之间危害平衡的影响。鉴于对敏感方法的偏好,强调了在筛查时需要对包括不确定性(CFSPID)在内的潜在结局进行充分解释。需要更多研究以为CF筛查后结局不确定的儿童管理制定明确指南提供依据。