Providers’ Attitudes to Proposed Changes in the CCHD Screening Algorithm

Background: In 2020, a panel of experts published proposed simplifications to the current critical congenital heart disease (CCHD) screening algorithm for newborns. The proposed changes would likely result in a slightly higher false positive (FP) rate. These recommendations have not been formally endorsed by the American Academy of Pediatrics (AAP).

Methods: An anonymous electronic survey was sent to members of the Wisconsin Association for Perinatal Care, Wisconsin Guild of Midwives, Wisconsin Affiliate of the AAP, the AAP Section on Cardiology and Cardiac Surgery, the Pediheart online cardiology community and the Association of Women’s Health Obstetric and Neonatal Nurses regarding the current and proposed CCHD screening protocols.

Results: We received 335 responses to the survey. 87.7% were somewhat or extremely satisfied with the existing CCHD screening algorithm.
43.1% of respondents endorsed and 11.2% opposed the proposed changes. 45.6% did not wish to comment. Willingness to endorse was associated with increasing familiarity with these changes (P = 0.001) but was not associated with field of practice, years of experience or familiarity with the current screening protocol.
79% of respondents were willing to accept a higher false positive (FP) rate in CCHD screening, with 46% willing to accept a doubling of the FP rate. However, those providers who would have to transfer a baby from the birth location for evaluation after a failed screening were less willing to accept a higher FP rate (P < 0.001).

Conclusion: Survey respondents expressed both a satisfaction with the existing CCHD screening protocol as well as some degree of support for the proposed changes in the algorithm. Those respondents most familiar with the proposed changes were most likely to endorse them but those who would have to transfer babies for evaluation after a failed CCHD screening were the least willing to accept a higher false positive rate.