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Franková V, Driscoll RO, Jansen ME, Loeber JG, Kožich V, Bonham J, Borde P, Brincat I, Cheillan D, Dekkers E, Fingerhut R, Kuš IB, Girginoudis P, Groselj U, Hougaard D, Knapková M, la Marca G, Malniece I, Nanu MI, Nennstiel U, Olkhovych N, Oltarzewski M, Pettersen RD, Racz G, Reinson K, Salimbayeva D, Songailiene J, Vilarinho L, Vogazianos M, Zetterström RH, Zeyda M. Regulatory landscape of providing information on newborn screening to parents across Europe. Eur J Hum Genet 2020; 29:67-78. [PMID: 33040093 DOI: 10.1038/s41431-020-00716-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/06/2020] [Accepted: 08/25/2020] [Indexed: 11/09/2022] Open
Abstract
Newborn screening (NBS) is an important part of public healthcare systems in many countries. The provision of information to parents about NBS is now recognised as an integral part of the screening process. Informing parents on all aspects of screening helps to achieve the benefits, promote trust and foster support for NBS. Therefore, policies and guidelines should exist to govern how the information about NBS is provided to parents, taking into account evidence-based best practices. The purpose of our survey was to explore whether any legally binding provisions, guidelines or recommendations existed pertaining to the provision of information about NBS to parents across Europe. Questions were designed to determine the regulatory process of when, by whom and how parents should be informed about screening. Twenty-seven countries participated in the survey. The results indicated that most countries had some sort of legal framework or guidelines for the provision of information to parents. However, only 37% indicated that the provision of information was required prenatally. The majority of countries were verbally informing parents with the aid of written materials postnatally, just prior to sample collection. Information was provided by a neonatologist, midwife or nurse. A website dedicated to NBS was available for 67% of countries and 89% had written materials about NBS for parents. The survey showed that there is a lack of harmonisation among European countries in the provision of information about NBS and emphasised the need for more comprehensive guidelines at the European level.
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Affiliation(s)
- Věra Franková
- Department of Paediatrics and Inherited Metabolic Disorders, Charles University First Faculty of Medicine and General University Hospital, Prague, Czech Republic. .,Institute for Medical Humanities, Charles University First Faculty of Medicine, Prague, Czech Republic.
| | - Riona O Driscoll
- Department of Paediatrics and Inherited Metabolic Disorders, Charles University First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Marleen E Jansen
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - J Gerard Loeber
- International Society for Neonatal Screening Office, Bilthoven, The Netherlands
| | - Viktor Kožich
- Department of Paediatrics and Inherited Metabolic Disorders, Charles University First Faculty of Medicine and General University Hospital, Prague, Czech Republic.
| | - James Bonham
- Division of Pharmacy, Diagnostics and Genetics, Sheffield Children's NHS Foundation Trust, Sheffiled, UK
| | | | | | | | - Eugenie Dekkers
- RIVM Centre for Population Screening, Bilthoven, The Netherlands
| | | | | | | | - Urh Groselj
- UMC-University Children's Hospital, Ljubljana, Slovenia
| | | | - Mária Knapková
- Children's University Hospital, Banska Bystrica, Slovakia
| | | | | | - Michaela Iuliana Nanu
- National Health Programs Management Unit of National Institute for Mother & Child Health, Bucharest, Romania
| | - Uta Nennstiel
- Screening Center of the Bavarian Health and Food Safety Authority, Oberschleissheim, Germany
| | | | | | - Rolf D Pettersen
- Norwegian National Unit for Newborn Screening, Oslo University Hospital, Oslo, Norway
| | - Gabor Racz
- Department of Paediatrics, University of Szeged, Szeged, Hungary
| | | | - Damilya Salimbayeva
- Scientific centre of Gynaecology, Obstetrics and Perinatology, Almaty, Kazakhstan
| | | | - Laura Vilarinho
- National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | | | - Rolf H Zetterström
- Centre for inherited metabolic diseases, Karolinska University Hospital, Solna, Sweden
| | - Maximilian Zeyda
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
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Driscoll RO, Zhou L, Moxness M, Mytych D, Chirmule N, Jawa V. Statistical and bioanalytical considerations for establishing a depletion criterion for specificity testing during immunogenicity assessment of a biotherapeutic. AAPS J 2013; 15:1160-7. [PMID: 23990502 DOI: 10.1208/s12248-013-9523-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 08/05/2013] [Indexed: 11/30/2022]
Abstract
Immunogenicity assessment of fully human monoclonal antibody-based biotherapeutics requires sensitive and specific ligand binding assays. One of the components of specificity is the depletion of signal by a relevant biotherapeutic that is commonly based on an arbitrary depletion criterion of inhibition of the original response or reduction of the signal below the screening assay cut point (ACP). Hence, there is a need to develop a statistically derived physiologically relevant specificity criterion. We illustrate an optimization approach to determine the concentration of biotherapeutic required for the specificity evaluation. Naïve donor sample sets with and without circulating drug and antitherapeutic/drug antibody (ADA) were prepared. Next, a depletion cut point (DCP) using naïve and ADA-containing donor sets with the optimized biotherapeutic concentration was evaluated. A statistically derived design of experiment was used to establish a validated DCP. A reliable DCP requires naïve (no ADA) donors treated only with an optimized concentration of biotherapeutic. The additional DCPs generated using two distinct concentrations of ADA-spiked sample sets led to a physiologically irrelevant criterion that was not necessarily representative of real-time samples. This increased the risk of false positives or negatives. In this study, well-defined bioanalytical and statistical methods were employed to validate a DCP to confirm the presence of biotherapeutic specific ADA in human serum samples. A physiologically relevant and effective strategy to confirm specificity in immune reactive samples, especially those that are close to the ACP, is proposed through this study.
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Affiliation(s)
- R O Driscoll
- Clinical Immunology, Amgen Inc., One Amgen Center Drive, 30E-3-C, Thousand Oaks, California, 91320, USA
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