Clinician reviewers in birth defects surveillance programs

Survey of the National Birth Defects Prevention Network

Angela E. Lin, Mathias B. Forrester, Christopher M Cunniff, Cathleen A. Higgins, Marlene Anderka

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND: Some birth defects surveillance programs utilize a clinician reviewer ("Clinician") to assist the multidisciplinary staff in the process of case review, coding and classification. The untested assumption is that expertise in the evaluation of individuals with birth defects and genetic syndromes in clinical practice, usually clinical genetics, is useful in reviewing medical records. METHODS: We conducted an exploratory survey of the 50 functioning birth defects surveillance programs that participated in the National Birth Defects Prevention Network in 2004. The survey was mailed electronically to program coordinators and included 10 questions with check-off option replies. Open-ended comments were also solicited. RESULTS: Responses were received from 31 of 50 (62%) programs, 21 (68%) which used a Clinician. In addition to the 9 centers that identified themselves as participants in the National Birth Defects Prevention Study (NBDPS), there were 12 non-NBDPS programs using a Clinician, 2 of whom were not clinical geneticists (1 nurse genetic counselor and 1 primary pediatrician). A total of 86% (18/21) of Clinicians were employed part-time or as consultants; 1 was full-time, and 2 were volunteers. In addition to the core activities of classifying defects and reviewing cases to determine if a syndrome was present, over one-half of the Clinicians participated in education of birth defects surveillance programs staff, research, and program development. Most (86%; 18/21) Clinicians had been trained informally for their roles. Only 1 had received a formal performance review. CONCLUSIONS: Aside from the 9 centers in the NBDPS in which the position of Clinician is funded by the Centers for Disease Control and Prevention (CDC), about one-half of the remaining respondent birth defects surveillance programs used a Clinician. Future research is needed to determine why a birth defects surveillance program hires or refrains from using a Clinician, and whether a Clinician accomplishes the desired goals. This survey reveals a lack of formal training for the Clinicians in their roles in the surveillance programs, and a lack of quality monitors, which might be addressed in the future.

Original languageEnglish (US)
Pages (from-to)781-786
Number of pages6
JournalBirth Defects Research Part A - Clinical and Molecular Teratology
Volume76
Issue number11
DOIs
StatePublished - Nov 2006

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Surveys and Questionnaires
Staff Development
Program Development
Centers for Disease Control and Prevention (U.S.)
Consultants
Medical Records
Volunteers
Nurses
Education
Research
Counselors
Pediatricians

Keywords

  • Birth defects monitoring program
  • Classification
  • Clinical geneticist
  • Coding
  • Surveillance program
  • Syndrome delineation

ASJC Scopus subject areas

  • Developmental Biology

Cite this

Clinician reviewers in birth defects surveillance programs : Survey of the National Birth Defects Prevention Network. / Lin, Angela E.; Forrester, Mathias B.; Cunniff, Christopher M; Higgins, Cathleen A.; Anderka, Marlene.

In: Birth Defects Research Part A - Clinical and Molecular Teratology, Vol. 76, No. 11, 11.2006, p. 781-786.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Some birth defects surveillance programs utilize a clinician reviewer ({"}Clinician{"}) to assist the multidisciplinary staff in the process of case review, coding and classification. The untested assumption is that expertise in the evaluation of individuals with birth defects and genetic syndromes in clinical practice, usually clinical genetics, is useful in reviewing medical records. METHODS: We conducted an exploratory survey of the 50 functioning birth defects surveillance programs that participated in the National Birth Defects Prevention Network in 2004. The survey was mailed electronically to program coordinators and included 10 questions with check-off option replies. Open-ended comments were also solicited. RESULTS: Responses were received from 31 of 50 (62{\%}) programs, 21 (68{\%}) which used a Clinician. In addition to the 9 centers that identified themselves as participants in the National Birth Defects Prevention Study (NBDPS), there were 12 non-NBDPS programs using a Clinician, 2 of whom were not clinical geneticists (1 nurse genetic counselor and 1 primary pediatrician). A total of 86{\%} (18/21) of Clinicians were employed part-time or as consultants; 1 was full-time, and 2 were volunteers. In addition to the core activities of classifying defects and reviewing cases to determine if a syndrome was present, over one-half of the Clinicians participated in education of birth defects surveillance programs staff, research, and program development. Most (86{\%}; 18/21) Clinicians had been trained informally for their roles. Only 1 had received a formal performance review. CONCLUSIONS: Aside from the 9 centers in the NBDPS in which the position of Clinician is funded by the Centers for Disease Control and Prevention (CDC), about one-half of the remaining respondent birth defects surveillance programs used a Clinician. Future research is needed to determine why a birth defects surveillance program hires or refrains from using a Clinician, and whether a Clinician accomplishes the desired goals. This survey reveals a lack of formal training for the Clinicians in their roles in the surveillance programs, and a lack of quality monitors, which might be addressed in the future.",
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