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Genomisk enhetlig screening mot sällsynta sjukdomar hos alla nyfödda (GUARDIAN)

18 september 2026 uppdaterad av: Rudolph L. Leibel, Columbia University

The goal of this study is to learn how genomic sequencing technology can be used to effectively expand the conditions screened on newborn screening. Newborn screening ensures equity and allows all babies to have the same chance at the healthiest life. Families will be invited to have their newborn baby screened for additional conditions beyond what all babies are screened for as part of the newborn screening public health program. Families can choose to be part of the study or choose not to be part of the study and just have the routine newborn screening test. Families will also be able to choose to learn about their baby's risk for conditions that have effective treatments available but are not on the routine newborn screening panel or also learn about conditions for which there is not currently FDA approved medications but for which medications are under development or for which early intervention services or treatment of seizures may improve the child's outcome. Families will be invited to the study shortly after the baby is born and will learn the decision not to participate, and we will interview a subset of parents who agree to be interviewed. Newborns who screen positive will be referred to appropriate providers for care and will be followed through review of electronic medical records and parental follow up via phone, text, postal mail or email.

Studieöversikt

Detaljerad beskrivning

Newborn screening (NBS) is the process of screening all newborns for select conditions shortly after birth. This process reduces morbidity and mortality by the detection of medically actionable conditions in pre-symptomatic newborns. Approximately 1 in every 180 newborns is diagnosed with a condition through NBS. NBS is a public health service; every infant regardless of health insurance or ability to pay is tested. NBS ensures equity and allows all babies to have the same chance at the healthiest life. Effective NBS requires coordination and collaboration from multiple stakeholders - the parents, the hospital of birth, state department of health lab, the pediatrician, and the specialty referral center.

Conditions included on the NBS must fulfill several criteria: 1) significant clinical benefit for the newborn early in life including treatment administered within the first few years of life, 2) readiness of public health departments to effectively screen for the condition, and 3) feasibility of successful implementation of population screening. In the United States, screening of newborns is under the purview of state public health departments. Each state decides which disorders to screen, and expansions to each state's panel of screened conditions. The federal government also plays a role through the Secretary of Health and Human Services (HHS) Advisory Committee on Heritable Disorders in Newborns and Children (ACHDNC). With rapid improvements in screening technology, diagnostic testing, and treatments, conditions not previously screened through NBS are being considered. Expanding NBS through genome-wide sequencing (GS) will be the most flexible and cost-effective way to add to what is currently in use.

Studietyp

Interventionell

Inskrivning (Beräknad)

100000

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

    • New York
      • New York, New York, Förenta staterna, 10032
        • Rekrytering
        • Columbia University Irving Medical Center/NYP
        • Huvudutredare:
          • Rudolph Leibel, MD
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

1 dag till 1 månad (Barn)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Newborns admitted to the well-baby nurseries from the recruiting hospitals
  • Newborns born after 33 weeks of gestation
  • Newborns whose parents are English, Mandarin, or Spanish speaking

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Undersökning
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Enrolled in the study

All newborns enrolled in the study will be evaluated.

Dried blood spots collected at birth for routine newborn screening will be used for genome sequencing based screening of a defined set of conditions.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Enrollment Rate (percentage)
Tidsram: From study launch to end of enrollment (up to 5 years)

Enrollment rate will be defined as: number of enrolled newborns / number of newborns approached by the research assistant.

From study launch to end of enrollment (up to 5 years)
Successful Sequencing Rate (percentage)
Tidsram: Up to 6 months after the end of enrollment

Successful sequencing rate will be defined as: number of successful sequencing / number of enrolled newborns.

Up to 6 months after the end of enrollment
Screen Positive Rate (percentage)
Tidsram: Up to 6 months after the end of enrollment

Screen positive rate will be defined as: number of newborns with a positive screening / number of successful sequencing.

Up to 6 months after the end of enrollment
True Positive Rate (percentage)
Tidsram: Up to 6 months after the end of enrollment

True positive rate will be defined as: number of confirmed diagnosis / number of screen positive.

Up to 6 months after the end of enrollment

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Score on Decision Regret Scale
Tidsram: Up to 6 months after the end of enrollment

The Decision Regret Scale measures distress or remorse after a health care decision. This 5-items scale ranges from 0 (no regrets - best outcome) to 100 (highest regret - worst outcome). Scores above 1 and below 25 are considered as an indication of mild regret. Scores above 25 are considered as an indication of moderate to severe regret.

Up to 6 months after the end of enrollment

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Utredare

  • Huvudutredare: Wendy K. Chung, MD, PhD, Boston Children's Hospital

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Användbara länkar

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

6 september 2022

Primärt slutförande (Beräknad)

1 september 2029

Avslutad studie (Beräknad)

1 september 2029

Studieregistreringsdatum

Först inskickad

4 augusti 2023

Först inskickad som uppfyllde QC-kriterierna

10 augusti 2023

Första postat (Faktisk)

14 augusti 2023

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

21 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

18 september 2026

Senast verifierad

1 september 2026

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • AAAS9161

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

IPD-planbeskrivning

IPD will not be shared with other researchers.

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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