{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T08:09:01Z","timestamp":1769501341571,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T00:00:00Z","timestamp":1560211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Optimal newborn screening thyroid\u2010stimulating hormone (TSH) cut\u2010offs are contentious. Analysis of demographic factors that impact screen TSH levels may help explain international variance and provide guidance to screening programmes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the influence of demographic factors on newborn screening TSH levels and screening performance parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Setting<\/jats:title><jats:p>National, retrospective population study using blood spot TSH cards from the New Zealand newborn screening programme in 2010\u20102015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>325\u00a0685 blood spot cards.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Likelihood of exceeding specific TSH thresholds (TSH \u22655, \u226510 and \u226515\u00a0mIU\/L) and group\u2010specific screening performance parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The likelihood of high TSH levels differed between ethnic groups. Pacific Island infants were more than twice as likely to have high\u2010normal TSH levels (\u22655 and \u226510\u00a0mIU\/L) and nearly twice as likely to have a positive screen (\u226515\u00a0mIU\/L) as New Zealand Europeans. M\u0101ori or Chinese ethnicity, male sex, younger gestational age and greater socio\u2010economic deprivation scores were also associated with high\u2010normal TSH levels. At a TSH threshold \u226515\u00a0mIU\/L, screening sensitivity was lowest (88.89% vs 95.83% overall) and PPV greatest (88.89% vs 62.84%) amongst Asian infants. Early samples were more than three times as likely to reach the screen\u2010positive threshold and more likely to yield a false\u2010positive result (PPV 20.00% vs 68.87%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Newborn TSH levels are impacted by a number of demographic variables, particularly ethnicity and age at sample collection. Screening performance may be improved through the use of targeted thresholds.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14044","type":"journal-article","created":{"date-parts":[[2019,6,4]],"date-time":"2019-06-04T12:34:51Z","timestamp":1559651691000},"page":"456-463","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The impact of demographic factors on newborn TSH levels and congenital hypothyroidism screening"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2895-3279","authenticated-orcid":false,"given":"Natasha L.","family":"Heather","sequence":"first","affiliation":[{"name":"LabPlus, Auckland District Health Board Newborn Metabolic Screening Programme Auckland New Zealand"},{"name":"Liggins Institute University of Auckland Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1226-1956","authenticated-orcid":false,"given":"Jos\u00e9 G. B.","family":"Derraik","sequence":"additional","affiliation":[{"name":"Liggins Institute University of Auckland Auckland New Zealand"},{"name":"A Better Start \u2013 National Science Challenge University of Auckland Auckland New Zealand"},{"name":"Department of Women's and Children's Health Uppsala University Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dianne","family":"Webster","sequence":"additional","affiliation":[{"name":"LabPlus, Auckland District Health Board Newborn Metabolic Screening Programme Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8995-8711","authenticated-orcid":false,"given":"Paul L.","family":"Hofman","sequence":"additional","affiliation":[{"name":"Liggins Institute University of Auckland Auckland New Zealand"},{"name":"Starship Children's Hospital Auckland District Health Board Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,6,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-17-0107"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2010.190280"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(16)30122-X"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-1822"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13250"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-1903"},{"key":"e_1_2_9_8_1","unstructured":"Statistics New Zealand.Population of New Zealand.2018.https:\/\/www.stats.govt.nz\/. Accessed 29 January 2019."},{"key":"e_1_2_9_9_1","unstructured":"AtkinsonJ SalmondC CramptonC.NZDep2013 Index of Deprivation.Wellington New Zealand:University of Otago;2014."},{"key":"e_1_2_9_10_1","volume-title":"Ethnicity data protocols for the health and disability sector","author":"Ministry of Health","year":"2004"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-1562"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu8050298"},{"key":"e_1_2_9_13_1","unstructured":"Ministry of Health Education counts.www.educationcounts.govt.nz\/statistics[Accessed 29 January 2019]."},{"key":"e_1_2_9_14_1","volume-title":"Household incomes in New Zealand: trends in indicators of inequality and hardship 1982 to 2017","author":"Perry B","year":"2018"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0133"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-3191"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0092"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1073"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.174466"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2008.147884"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-0915"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-1891"},{"key":"e_1_2_9_23_1","volume-title":"Blood collection on filter paper for newborn screening programmes; approved standard \u2013 sixth edition","author":"Clinical and Laboratory Standards Institute","year":"2013"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI106132"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-1759"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2015.154"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.09.003"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.14044","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cen.14044","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.14044","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T12:37:51Z","timestamp":1694263071000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.14044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,11]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1111\/cen.14044"],"URL":"https:\/\/doi.org\/10.1111\/cen.14044","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,11]]},"assertion":[{"value":"2019-03-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}