Implementation of written consent for newborn screening in Victoria, Australia
- Conflict of Interest: The authors have no conflicts of interest to disclose.
- Funding Source: This work was funded by the Victorian Department of Health.
- Financial Disclosure: The authors have no financial relationships relevant to this article.
- Disclaimer: The views and conclusions are those of the authors and do not necessarily represent those of the Victorian Department of Health.
- Contributor statement:Taryn Charles: Ms Charles was the senior project officer who lead the written consent trial and subsequent implementation, drafted the initial manuscript and approved the final manuscript as submitted.
- James Pitt: Dr Pitt analysed the laboratory data, reviewed and revised the manuscript, and approved the final manuscript as submitted.
- Jane Halliday: Professor Halliday analysed laboratory data, critically reviewed and revised the manuscript, and approved the final manuscript as submitted.
- David J. Amor: Dr Amor analysed laboratory data, critically reviewed and revised the manuscript, and approved the final manuscript as submitted.
There has been increasing evidence of a lack of public awareness of newborn screening and concern about inadequate consent being obtained from parents. Apprehension also exists in relation to storage and secondary use of screening samples. Our objective was to introduce a written consent process across Victoria as a means of strengthening programme transparency, quality and supporting parental choice. In addition, more comprehensive information covering all aspects of the programme was developed.
A ‘two-stage’ written consent protocol allowed parents to give separate consent for (i) their baby to be screened and (ii) secondary use of the sample in de-identified health research. At the time of sample collection, parents were asked to complete the consent form, included as part of the screening card. The protocol was piloted in four public hospitals and subsequently implemented statewide.
Twelve months of laboratory data showed that although refusals for screening increased, overall participation remained above 99%. The percentage of parents opting out of research use was 6.5%. Provider compliance with the new protocol was high, with only 1.4% of cards received without a completed consent form.
This quality improvement project has demonstrated that parents can participate more fully in newborn screening without jeopardising high uptake. As a secondary benefit, the public health resource of stored cards can be maintained with parental support. Future work needs to examine the quality of consent being given by parents and investigation of the reasons why some choose to decline.