Day 1 - Sunday, October 16
This session will feature compelling personal accounts of how newborn screening impacts the lives of patients and families. Follow their journeys from screening and diagnosis to treatment and management and discover the small but powerful community of parents of children with disorders detected by newborn screening.
Moderators:
- Angelica Watkins, Washington State Public Health
- Lani Culley, MPH, Washington State Department of Health Laboratory
Speakers:
- Susan & Indie Mays
- Denise Bazemore
- Kendra Hogenson
Day 2 - Monday, October 17
7:00 - 8:00 am PST | Concurrent Roundtables
Exploration of Privacy-Enhancing Technologies to Ensure Patient Trust, Privacy, and Data Transparency in CDC ED3N
This roundtable will review relevant privacy enhancing technologies (PETs), caveats of use, and areas for future research and development. Of particular focus will be privacy-preserving record linkage, a technique to link data from the same patient across different sources in a way that does not compromise personally identifiable information (PII). PPRL can accelerate data sharing by minimizing the manual and labor-intensive processes common in healthcare. Lastly, the roundtable will describe efforts to deploy PETs as part of the Newborn Screening and Molecular Biology Branch’s (NSMBB) Enhancing Data-driven Disease Detection in Newborns (ED3N) platform. Integration of PETs into ED3N will help NBS programs harmonize and analyze their data in a responsible, reproducible manner.
Speaker:
- Amy Gaviglio, MS, CGC, Connetics Consulting/CDC/APHL
What Does Long-Term Follow-up Mean to You? A Discussion With State NBS Programs
Over 20,000 newborns are diagnosed each year with a congenital condition through the newborn screening (NBS) system. The majority of these conditions require life-long care and management, ideally with the care coordinated through a medical home, to assure the best possible outcomes for each diagnosed baby. All stakeholders in the NBS community play important roles in long-term follow-up (LTFU), but there is no national system of LTFU data collection, analysis, sharing, and reporting. In addition, LTFU activities, policies, and practices vary across state NBS programs. This roundtable will provide state NBS programs a forum to discuss their involvement in LTFU and to create a series of definitions of LTFU for each stakeholder group. A new initiative will also be described to capitalize on clinical care efforts to deliver LTFU into a centralized resource that will improve the insight of the benefits of NBS.
Speaker:
- Jennifer Taylor, PhD, American College of Medical Genetics and Genomics
A Community of Practice: Exploring Current Newborn Screening Result Communication Practices
This roundtable presentation will provide important preliminary data on parents’ experiences receiving initial newborn screening NBS results as revealed in survey responses from the current National Institute of Health (NIH) funded R01 project which asked parents of a child that received a false positive or normal initial NBS result about their communication experience. It will also create an opportunity for necessary information sharing and collaboration to improve these experiences moving forward with a goal to promote sharing of processes and procedures as well as successes and challenges between NBS program leadership and staff.
Speaker:
- Brianne Miller, MPH, Children’s National Hospital
This session will describe the landscape of newborn screening (NBS) in 2021 through present day and consider the challenges and opportunities now facing NBS programs. Such challenges and opportunities include establishing a biobank to support further understanding of NBS diseases; increasing knowledge and transparency about NBS processes to alleviate concerns; and developing a proposal for harmonizing how conditions are counted and named.
Moderators:
- Aaron Goldeberg, PhD, MPH, Case Western Reserve University
- Kim Hart, MS, LCGC Utah Department of Health and Human Services
Presentations:
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The State of Newborn Screening Systems in the United States in 2021–2022
Sikha Singh, MHS, PMP, Association of Public Health Laboratories
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Newborn Screening Modernization: Issues and Strategies
Don Bailey, PhD, RTI International
Development of a Biobank to Support Research for Current and Future Newborn Screening Disease Targets in Canada
Monica Lamoureux, MSc, PMP, CCRP, Children’s Hospital of Eastern Ontario
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Newborn Screening Research and Consent — A Review of the Current Landscape in the United States
Shibani Kanungo, MD, MPH, FAAP, FACMG, University of Western Michigan
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Newborn Screening Research and Consent — A Review of the Current Landscape in the United States
Shibani Kanungo, MD, MPH, FAAP, FACMG, University of Western Michigan
This session will focus on promoting equitable access to gene therapies and followup care for rare diseases, with the recognition that trust in public health systems has changed in recent years. Discussions will evaluate where the public health system currently stands in increasing access and equity in the care and treatmentof rare diseases and how a lack of trust in underserved populations affects the social contract that newborn screening (NBS) programs and other public health systems rely on to function.
Moderators:
- John Thompson, PhD, MPH, MPA, Washington State Public Health Laboratory
- Michele Caggana, ScD, FACMG, Wadsworth Center, New York Department of Health
Presentations:
The Future of Public Health, Challenges and Lessons Learned
Umair A. Shah, MD, MPH, Secretary of Health, Washington State Department of Health
Improving Access to Care in Sickle Cell Disease
Julie Kanter, MD, The University of Alabama at Birmingham
Assumptions, Access and Adults
Sandra Sirrs, MD, University of British Columbia
Emerging Therapeutic Platforms for Monogenic Disease and Implications for Newborn Screening
Philip J. (P.J.) Brooks, PhD, National Institutes of Health
This session will examine equity and disparity as it relates to the newborn screening (NBS) system by assessing whether the universality of NBS is maintained, and potential risk factors identified, through the screening and follow-up process. The session will also focus on the screening of cystic fibrosis (CF) and how to best address disparities in order to counter barriers to timeliness and equity. A discussion on the clinical perspective of health equity based on the experience of treating patients who have been traditionally marginalized will be had.
Moderators:
- Michelle Mills, MSFS, Kansas Department of Health and Environment
- Carla Cuthbert, PhD, FCCMG, FACMG, Centers for Disease Control and Prevention
Presentations:
Using NewSTEPs Data to Assess Disparities in Newborn Screening
Amy Gaviglio, MS, CGC, Connetics Consulting/CDC/APHL
Building Relationships to Reduce the Gaps: How Analysis of LFU Data Led to Newfound Partnerships, a More Comprehensive Educational Program, and Increased Equity Within Program Activities
Drew Duncan, MA, Kansas Department of Health
Towards Equity and Timeliness in Cystic Fibrosis Newborn Screening
Albert Faro, MD, Cystic Fibrosis Foundation
Stength of A Nation
Socia Love-Thurman, MD, Seattle Indian Health Board
This session will explore ways that newborn screening (NBS) programs are improving follow-up practices and creating better tools for communicating. It will discuss efforts to put families impacted by spinal muscular atrophy (SMA) first in the design of long-term follow-up (LTFU) tools; summarize ways to connect individuals with phenylketonuria lost to follow-up with services; compare cystic fibrosis (CF) and CF-Related Metabolic Syndrome (CRMS) patients; and describe the structure and value of a peer-to-peer learning exchange program for NBS short-term follow-up (STFU) programs.
Moderators:
Christen Crews, MSN, RN, Virginia Department of Health
Kelly Kramer, MPH, Washington State Public Health Laboratory
Presentations:
Putting Families First: Innovative Approaches of Long-Term Follow-up Cares and Check Initiative (LTFU-Cares & Check)
Jennifer Taylor, American College of Medical Genetics and Genomics
Pilot Project to Reconnect Michigan’s Lost to Follow-up Phenylketonuria Population with Information and Services
Kristy Karasinski, MPH, Michigan Department of Health & Human Services
The Forest or the Trees: 12 years’ Experience of CF, CRMS and Diagnostic Transitions Following Newborn Screening for CF in California
Stanley Sciortino, MPH, PhD, California Department of Public Health
Initial Success of the NewSTEPs Follow-up Learning Exchange (FLEX) Program
Erin Darby, MPH, MCHES, Association of Public Health Laboratories
6:00 - 6:30 pm PST | Meet the Manufacturers
Light-hearted presentations from Baebies and PerkinElmer, along with snacks and beverages.
Day 3 - Tuesday, October 18
7:00 - 8:00 am PST | Innovate! Sessions
- PerkinElmer
- Waters Integrated Software Soilutions
This session will examine newborn screening (NBS) systems with an international lens, in particular how NBS programs in the Netherlands expanded from 17 to 31 conditions — with an emphasis on improving timeliness and avoiding future false positives while screening Mucopolysaccharidosis type I (MPS I), the performance of Latin American labs participating in the Newborn Screening Quality Assurance Program (NSQAP), and the recent implementation of whole genome sequencing in the United Kingdom.
Moderators:
Joanne Mei, PhD, Centers for Disease Control and Prevention
M. Christine Dorley, PhD, MT(ASCP), Tennessee Department of Health,Laboratory Services
Presentations:
Expanded Neonatal Bloodspot Screening Programmes: A Framework to Prioritize New Conditions With Stakeholders
Marleen Jansen, PhD, Dutch National Institute for Public Health and the Environment
Performance Evaluation of Latin America Laboratories in the CDC Newborn Screening Quality Assurance Programs, 2016–2022
Ernesto Gonzalez Reyes, PhD, Centers for Disease Control and Prevention
Evaluation of the First Year of Screening for MPS I in The Netherlands
Rose Maase, PhD, C(ASCP)CM, MRSC, Dutch National Institute for Public Health and the Environment
Evaluating the Use of Whole Genome Sequencing in Newborn Screening: The Genomics England Newborn Genomes Programme
David Bick, MD, Genomics England
This session will examine how newborn screening (NBS) programs have created efficiencies in testing conditions on the RUSP. Examples include identifying optimal screening procedures for detecting infants with Primary Congenital Hypothyroidism (CH), presenting breakthrough methods for multiplexing total homocysteine (tHcy), examining ways to reduce the number of false positives and improve turn around time (TAT), analyzing how lysosomal storage disorders (LSDs) can benefit from NBS and determine ways metabolomics can be used as a tool in the expansion of screening for new disorders.
Moderators:
- Graham Sinclair, PhD, British Columbia Children’s Hospital
- Denise Kay, PhD, Wadsworth Center, New York State Department of Health
Presentations:
Congenital Hypothyroidism Detection in Texas: A Ginormous Study of T4 and TSH as Primary Analyte
Brendan Reilly, BS, Texas Department of State Health Services
Multiplexing Homocysteine into FIA-MS/MS Primary-Tier Screening with Amino Acids, Acylcarnitines, Succinylacetone, Adenosine, Deoxyadenosine and Other Biomarkers by Selective Homocysteine Derivatization
Austin Pickens, PhD, Centers for Disease Control and Prevention
Michigan’s Experience Transitioning from Digital Microfluidics to MS/MS for Lysosomal Storage Disorder Screening
Shawn Moloney, MPH, MLS (ASCP), Michigan Newborn Screening Laboratory
LDT Implementation for the Screening of X-ALD, Pompe Disease and MPS-I with One Dried Blood Spot Using LC-MS/MS
Nicolas Szabo, PhD, Utah Public Health Laboratory
Neonatal Screening for Peroxisomal Disorders: New and Novel Lipid Biomakers
Enzo Ranieri, PHD, Women’s and Children’s Hospital, Australia
This session will provide an overview of practices performed by newborn screening (NBS) programs to improve the quality of their programs. Presentations will include a review of tools used to facilitate virtual collaboration, updates on cases previously closed as Lost to Follow-up, a look into the development of harmonization frameworks, an examination of processes to improve communication, increase timeliness, and reduce the risk of human error, and share ways to streamline efforts between the lab, follow-up and external partners.
Moderators:
Lorrie Folmar, RN, BSN, Alaska Division of Public Health
Lisa Shook, MA, MCHES, Cincinnati Children’s Hospital Medical Center
Presentations:
Using Systems Design Thinking to Improve Internal Notifications Between Laboratory and Follow-up Components of the Kansas Newborn Screening Program, Part 1: Understanding the Current System, User Needs and Improvement Measures
Kinsey Anderson, MPH, Kansas Department of Health and Environment
A Quality Management Project with Inherited Metabolic Disorders Specialty Care Centers to Reduce Referrals Lost to Follow-up
Kathy Chou, PhD, New York State Department of Health
Development of Post-analytical Methodologies for the Uniform Interpretation of Newborn Screening Data
Nicolas Szabo, PhD, Utah Public Health Laboratory
Beyond the Fax Machine: Improving Operations and Communication between Follow-up, NBS Laboratory and NICU
Christen Crews, MSN, RN, Virginia Department of Health
Newborn Screening Follow-up Harmonization Project
Lani Culley, MPH, Washington Public Health Laboratories
This session will explore the various ways newborn screening (NBS) programs interact with parents and families throughout the screening process. Presentations will explore how programs communicate with communities, and the frustrations and limitations that can occur. Ideas on ways to improve processes from interviews with parents will also be discussed. In order for families to become leaders in the NBS system, adequate training strategies are required to improve confidence and agency. Exploring this parent perspective is integral to creating a public health system that works for everyone.
Moderators:
Sarah Viall, MSN, PPCNP-BC, Oregon Health & Science University
Carol Johnson, University of Iowa Hospitals and Clinics
Presentations:
Understanding Clinician Needs and Preferences with Respect to Returned NBS Results
Nicole Ruiz-Schultz, PhD, Utah Public Health Laboratory
Discrepancies between Parent-reported and Known NBS Results: Examining Parent Experiences with Qualitative Interviews
Anne Atkins, MPH, Children’s National Hospital
Engaging Family Leaders in the NBS System
Marianna Raia, MS, CGC, Expecting Health at Genetic Alliance
Developing an Integrated, Mixed-Methods Parent Engagement Research Program: The ScreenPlus ELSI Studies
Aaron Goldenberg, PhD, MPH, Case Western Reserve University
This session will feature presentations focused on genetic privacy in the context of new developments in rapid whole genome sequencing of newborns. Discussions will highlight a private industry perspective (presenting research efforts on rapid whole genome sequencing for rare disease diagnosis in newborns), a state perspective (the aftermath of a court ruling on the Texas NBS program’s storage and use of residual dried blood spots) and a legal perspective (the landscape of policies, regulations and statutes, or their absence, across state NBS programs governing access to residual dried blood spots and for what purposes).
Moderators:
Amy Gaviglio, MS, CGC, Connetics Consulting/CDC/APHL
Aaron Goldenberg, PhD, MPH, Case Western Reserve University
Presentations:
A new beginning – how newborn genomic sequencing can complement and expand current practices
Wendy Benson, MBA, Rady Children’s Institute for Genomic Medicine
Genetic Privacy and Newborn Screening – A State Program Perspective
Rachel Lee, PhD, HCLD, Texas Department of State Health Services
The Risks of Law Enforcement Access in Newborn Screening
Natalie Ram, JD, University of Maryland Carey School of Law
Day 4 - Wednesday, October 19
7:00 - 8:00 am PST | Concurrent Roundtables
Hemoglobinopathy Newborn Screening: Is It Time to Increase Molecular Testing?
Every Newborn Screening (NBS) program in the US and its territories assesses for hemoglobinopathies utilizing isoelectric focusing electrophoresis (IEF) and/or High-Performance Liquid Chromatography (HPLC) techniques. While these methods are robust, in several instances molecular methods become necessary to precisely identify the hemoglobin variant or thalassemia genotype. Currently, the number of state and territorial NBS programs that have access to molecular testing as well as the methodologies they used were determined through a nationwide survey of these programs. This roundtable will discuss the results of a survey conducted in 2018 of all US state newborn screening programs to determine approaches used for detecting and reporting beta-thalassemia and whether states used molecular methods in their testing algorithm.
Speaker:
- Amanda Ingram, RN, Tennessee Department of Health
Embracing Expanded COVID-era Capabilities in Metabolic Newborn Screening (NBS) Follow-up in Oregon
This roundtable will review how the Metabolic Genetics Clinic adjusted to changes as a result of the COVID-19 pandemic. Discussion will include how they altered workflows in unprecedented ways to provide uninterrupted expedient follow-up of potentially affected babies while expanding remote collaboration with newborn screening (NBS) program staff, rolling out telemedicine visits, adding contiguous state licenses and coordinating community follow-up diagnostic test collection and treatment. Ultimately, as the public health crisis enters a new phase, the followup program has been able to leverage many of capabilities resulting in a more flexible experience for families and other stakeholders, including expanding remote collaboration, virtual education and telemedicine visits.
Speakers:
Sarah Viall, MSN, PPCNP-BC, Oregon Health Sciences University
Leah Wessenberg, FNP, MN, Oregon Health Sciences University
Good, Better, Best: Setting a Standard for the Newborn Screening Workforce of Today, Tomorrow and the Future
The roundtable session will engage participants in robust discussion on the outcomes of a survey aimed at identifying newborn screening (NBS) services and activities that are currently being conducted by state NBS programs and give input on next steps to develop guidance on standards for staffing a NBS program. Participants will be asked to break out into groups between various programs and explore a series of questions focusing on aspects of staffing components that make an effective NBS program. Roundtable outcomes will inform existing and future efforts to advance understanding of NBS programs’ needs and potential solutions to addressing workforce challenges.
Speaker:
- Susan Tanksley, PhD, Texas Department of State Health Services
This session will evaluate how data analytics and bioinformatics can help address challenges and create opportunities for newborn screening (NBS) programs. Presentations will include a description of the efforts made to simplify the addition of next generation sequencing within NBS programs, ways in which a database can facilitate and streamline variant data collection, interpretation and reporting, and an overview of current recommendations and practices for sequencing and variant classification.
Moderators:
Charles Lechner, MS, Tennessee Department of Health: Laboratory Services
Christian Alcorta, MS, Virginia Division of Consolidated Laboratory Services
Presentations:
Creating a National Newborn Screening Bioinformatics and Variant Interpretation Tool: LIMS Lite and ED3N
Amy Gaviglio, MS, CGC, Connetics Consulting/CDC/APHL & David E. Jones, PhD, Centers for Disease Control and Prevention
Benefits and Burdens of Gene Variant Analysis in the Newborn Screening Setting
Denise Kay, PhD, Wadsworth Center, New York State Department of Health
Creation of a Variant Analysis Pipeline for Texas Newborn Screening DNA Sequencing
Samantha Marcellus, MPH, Texas Department of State Health Services
This session will summarize newborn screening (NBS) for various types of conditions to better understand screening outcomes in premature newborns and practices that reduce unnecessary follow-up activities. Conditions include NBS for Severe Combined Immunodeficiency (SCID) by measurement of T-cell receptor excision circles (TRECs), molecular investigation of Idiopathic T-cell Lymphopenia and expanded screening for Cystic Fibrosis (CF) and Krabbe disease.
Moderators:
Suzanne Cordovado, PhD, Centers for Disease Control and Prevention
Sainan Wei, MD, PhD, Kentucky Division of Laboratory Services
Presentations:
Severe Combined Immunodeficiency (SCID) Screening for Premature Infants Quality Improvement Project
Ruthanne Sheller, MPH, Association of Public Health Laboratories & Amy Gaviglio, MS, CGC, Connetics Consulting/CDC/APHL
Molecular Investigation of Idiopathic T-cell Lymphopenia Cases in New York State
Denise Kay, PhD, Wadsworth Center, New York State Department of Health
Expanded Screening for Cystic Fibrosis - No Sweat
Michael Cellucci, MD, Delaware Newborn Screening Program
The p.Y319C GALC Variant and Newborn Screening for Krabbe Disease
Dietrich Matern, MD, PhD, Mayo Clinic
This session will evaluate methods of technology used to support newborn screening (NBS) programs including how electronic data exchange can impact hospital engagement, the approaches and tools utilized to help NBS programs better understand and implement their interoperability goals and how to improve future Continuity of Operations Plans (COOP) when faced with technology issues.
Moderators:
Brendan Reilly, BS, Texas Department of State Health Services
Stanley Sciortino, MPH, PhD, California Department of Public Health
Presenations:
Promoting Newborn Screening Interoperability — How to Effectively Communicate Benefits to Improve Hospital Engagement
Emily Hopkins, MS, Virginia Division of Consolidated Laboratory Services
Advancing Electronic Data Sharing for Newborn Screening Programs
Craig Newman, PhD, Altarum
Utilizing a Data Exchange to Achieve Interoperability in Newborn Screening
Heather Brand, Minnesota Department of Health Newborn Screening
Improving COOP in South Carolina: Lessons Learned from Memorial Day Weekend 2021
Elizabeth Bair, MS, South Carolina Dept of Health & Environmental Control
This session will explore testing for congenital cytomegalovirus (cCMV) and Duchenne Muscular Dystrophy (DMD) in three states. Presenters will discuss the efficiency of CMV dried blood spot (DBS) testing methods, share data from testing dried blood spots using real-time PCR and discuss implementation efforts of testing for CMV in Minnesota. North Carolina will discuss the screening of DMD through the Early Check NBS study, which offers consented screening for conditions currently not a part of routine NBS. New York will evaluate the screening for DMD as part of a pilot study that will help to determine recommendation for states implementing screening.
Moderators:
Mei Baker, MD, FACMG, Wisconsin State Laboratory of Hygiene
Pranesh Chakraborty, PhD, Newborn Screening Ontario
Presentations:
Clinical Sensitivity of Dried Blood Spots and Saliva for Detection of Congenital Cytomegalovirus Disease
Tatiana Lanzieri, MD, MPH, Centers for Disease Control and Prevention
Evaluation of Testing for Congenital Cytomegalovirus in Dried Blood Spot Using Real-Time PCR in Minnesota
Carrie Wolf, MBS, Minnesota Department of Health
Early Check Newborn Screening Pilot Study for Duchenne and Related Muscular Dystrophies in North Carolina
Holly Peay, PhD, MS, RTI International
Factors Influencing Creatine Kinase-MM Levels in Newborns and the Relevance for Newborn Screening for Duchenne Muscular Dystrophy
Norma Tavakoli, PhD, Wadsworth Center, New York State Department of Health
Day 5 - Thursday, October 20
Moderators:
- Enzo Ranieri, pHd (he/him/his) – Directorate of Genetics & Molecular
- Joanne Mei, PhD, Centers for Disease Control and Prevention
Presentations:
ISNS Activities
Peter Schielen, PhD International Society for Neonatal Screening
The need for certainty in Newborn Screening, implications for genomic testing
Jim R. Bonham, MSc, PhD, CSci, FRCPath, International Society for Neonatal Screening
Developing Newborn Screening in low and middle income countries, a joint effort
Dianne Webster, PhD, Newborn Screening New Zealand, Auckland District Health Board
This session will evaluate the current state of second-tier screening, the methods used, and the challenges associated with either adopting in-house second-tier screening or sending testing to a reference laboratory. Ways to improve screening performance for Mucopolysaccharidosis Type I (MPSI), lysosomal disorders glycogen storage disease type II (Pompe), homocystinuria (HCU) and HCU-ReMet disorders and vitamin B12 deficiency will be discussed.
Moderators:
Ewa King, PhD, Association of Public Health Laboratories
Joseph Orsini, PhD, New York State Department of Health
Presentations:
The Changing Landscape of Mass Spectrometry-based Biochemical Second-tier Newborn Screening
Kostas Petritis, PhD, Center for Disease Control and Prevention
Newborn Screening for Mucopolysaccharidoses: Evolution and Improvement of a Two-tier Screening Approach
Patricia Hall, PhD, Mayo Clinic
Dual 2nd-tier Screening of Lysosomal Disorders Glycogen Storage Disease Type II (Pompe) and Mucopolysaccharidosis I (MPS I) with Biochemical and Sequencing — A Comparison of Data, Benefits and Outcomes
Michelle Mills, MS, Kansas Department of Health and Environment
Newborn Screening for the Homocystinurias (Classical Homocystinuria and Remethylation Disorders) — Expanding and Improving Biomarkers and Algorithms
Devinder Kaur, PhD, New England Newborn Screening Program
Vitamin B12 Deficiency: Implications for Newborn Screening
Graham Sinclair, PhD, British Columbia Children’s Hospital
This session will explore various pilot studies for newborn screening (NBS). It will reflect on whether the length of a pilot study affects long-term follow-up (LTFU) data, how the amount of time spent on laboratory work is affected when a new pilot study is implemented, how pilot studies provide critical evidence to assess the appropriateness of candidate disorders for population wide NBS and whether early detection of diseases can improve quality of life and result in lower provider and testing costs.
Moderators:
Aranjeet Singh, MA, MCHES, Washington State Public Health Laboratory
Susan Berry, MD, University of Minnesota
Presentations:
Reimaging Newborn Screening Pilots: Models, Mining and More
Jennifer Taylor, PhD, American College of Medical Genetics and Genomics
It Takes a System: Implementation of Screening for Pompe Disease, MPS I and Krabbe Disease in Georgia — Pilot Studies, Post-analytical Tools, Second-tier Testing and a Lot of Communication
Patricia Hall, PhD, Mayo Clinic
ScreenPlus: A Pilot Study to Screen for 14 Disorders: Overview, Challenges and Preliminary Results
Joseph Orsini, PhD, Wadsworth Center, New York State Department of Health
Staged Newborn Screening for Common Childhood Diseases — The Combined Antibody Study for Celiac And Diabetes Evaluation (CASCADE Study)
William Hagopian, MD, PhD, University of Washington