The feasibility of using ethnicity as a primary tool for antenatal selective screening for sickle cell disorders: pointers from the research evidence
The feasibility of using ethnicity as a primary tool for antenatal selective screening for sickle cell disorders: pointers from the research evidence
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DOI：
10.1016/s0277-9536(02)00027-8
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发表时间：
2003-01-01
影响因子：
5.4
通讯作者：
Anionwu, EN
中科院分区：
文献类型：
--
作者：
Aspinall, PJ;Dyson, SM;Anionwu, EN
卫生部宣布，到 2004 年，在英国国民保健服务的一项综合国家计划中，将实施一项针对血红蛋白病的产前和新生儿筛查计划。作为回应，国家筛选委员会已开始研究如何最好地实施这一计划，包括调查作为选择基础的种族出身问题的有效性。此外，最近的两份卫生技术评估报告评估了英国产前和新生儿血红蛋白病筛查计划的替代方案。报告和评论员都强调了开发收集种族数据的标准化工具的重要性，并建议尽早开展此类工作。对使用种族作为主要筛选工具的证据进行的检查显示，实践和收集的数据质量存在很大差异，风险组错误分类高达 20%，而建议目标为 5.5% 以下。回顾了有关种族问题的概念基础和结构、数据收集分配方法以及分类分辨率水平的文献，以确定血红蛋白病筛查问题的最合适的内容和格式。对问题选项进行评估，包括使用扩展的 2001 年人口普查分类和“非北欧”标识符，并提供基于“家庭出身”的候选问题进行辩论。最后，讨论了与种族问题的效率测试及其在产前镰状细胞筛查中的应用相关的问题。 (C) 2002 年，爱思唯尔科学有限公司出版。
The Department of Health has announced a linked antenatal and neonatal screening programme for haemoglobinopathies by 2004 in a comprehensive national plan for the National Health Service in Britain. In response the National Screening Committee has commenced development work on how such a programme can best be implemented, including investigation of the effectiveness of a question about ethnic origin as a basis for selection. In addition, two recent health technology assessment reports have assessed alternative options for antenatal and neonatal haemoglobinopathy screening programmes in the United Kingdom. Both reports and commentators have emphasised the importance of developing a standardised instrument for collecting ethnicity data and recommended early development of such work. An examination of the evidence base on the use of ethnicity as a primary screening tool reveals substantial variability in practice and in the quality of data collected, with risk group misclassification as high as 20% against a recommended target of under 5.5%. The literature on the conceptual basis and structure of ethnicity questions, method of assignment in data collection, and level of resolution on categorisation is reviewed to identify the most appropriate content and format of a screening question for the haemoglobinopathies. Question options are evaluated, including the use of an extended 2001 Census classification and a 'non-North European' identifier and a candidate question based on 'family origins' is offered for debate. Finally, issues relating to the testing of the efficiency of an ethnicity question and the operationalising of its use for antenatal sickle cell screening are discussed. (C) 2002 Published by Elsevier Science Ltd.