Cystic Fibrosis Clinical Trial
Official title:
Pulmonary Benefits of Cystic Fibrosis Neonatal Screening
Although cystic fibrosis (CF) is the most common, life-threatening autosomal recessive
genetic disorder of the white population, there are often delays in diagnosis and hence
start of treatment. Advances of the past two decades have made CF screening feasible using
routinely collected neonatal blood specimens and measuring an enzyme level followed by CF
mutation DNA analysis. Our overall goal of the study is to see if early diagnosis of CF
through neonatal screening will be medically beneficial without major risks. ''Medically
beneficial'' refers to better nutrition and/or pulmonary status, whereas '' risks'' include
laboratory errors, miscommunication or misunderstanding, and adverse psychosocial
consequences. Specific aims include assessment of the benefits, risks, costs, quality of
life, and cognitive function associated with CF neonatal screening and a better
understanding of the epidemiology of CF.
A comprehensive, randomized clinical trial emphasizing early diagnosis as the key variable
has been underway since 1985. Nutritional status has been assessed using height and weight
measurements and biochemical methods. The results have demonstrated significant benefits in
the screened (early diagnosis) group. We are now focusing on the effect of early diagnosis
of CF on pulmonary outcome. Pulmonary status is measured using chest radiographs, chest
scans using high resolution computerized tomography, and pulmonary function tests. Other
factors that we are looking at include risk factors for the acquisition of respiratory
pathogens such as Pseudomonas aeruginosa, quality of life and cognitive function of children
with CF who underwent early versus delayed diagnosis, as well as the cost effectiveness of
screening and the costs of diagnosis and treatment of CF throughout childhood.
If the questions underlying this study are answered favorably, it is likely that neonatal
screening using a combination of enzyme level (immunoreactive trypsinogen) and DNA test will
become the routine method for identifying new cases of CF not only in the State of
Wisconsin, but throughout the country.
n/a
Allocation: Randomized, Intervention Model: Single Group Assignment, Primary Purpose: Diagnostic
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