LAUSR

Dear Editor, We thank Ewer et al. [1] for noting our error in stating “false-negative” rather than “false-positive” in our Commentary on “Pulse Oximetry Screening for Critical Congenital Heart Defects [2]. The journal of Neonatology has published an erratum [3]. We agree that the reason that pulse-oximetry screening before 24 h after birth is less accurate than after 24 h is lower specificity, that is, a higher false-positive rate. Although there is no evidence that anxiety is higher in mothers whose infants have a false-positive result than in mothers of infants with true-negative results, policymakers cite this as a key concern when evaluating screening programs [4, 5]. However, as Ewer et al. [1] highlight, screening after 24 h means that some infants with critical congenital heart disease present clinically with ductus-dependent anomalies prior to being screened. This is of particular importance for infants who are discharged from hospital within a few hours after birth, and has prompted adoption of two-stage pulse oximetry screening algorithms in settings where home births and very early discharge are common [6]. We agree that is it important for policy-makers to note that pulse oximetry screening, in addition to detecting congenital heart disease, identifies infants with respiratory or infectious morbidities that might benefit from early investigation, diagnosis, and management [7]. Disclosure Statement