Authors

Department of Information Technology, Health Information Technology, Health Vice-Chancellery, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Congenital hypothyroidism and phenylketonuria (PKU) are the most common
cause for preventable mental retardation in infants worldwide. Timely diagnosis and treatment
of these disorders can have lasting effects on the mental development of newborns. However,
there are several problems at different stages of screening programs that along with imposing
heavy costs can reduce the precision of the screening, increasing the chance of undiagnosed
cases which in turn can have damaging consequences for the society. Therefore, given these
problems and the importance of information systems in facilitating the management and
improving the quality of health care the aim of this study was to improve the screening process
of hypothyroidism and PKU in infants with the help of electronic resources. Methods: The
current study is a qualitative, action research designed to improve the quality of screening,
services, performance, implementation effectiveness, and management of hypothyroidism and
PKU screening program in Isfahan province. To this end, web‑based software was designed.
Programming was carried out using Delphi.net software and used SQL Server 2008 for database
management. Findings: Given the weaknesses, problems, and limitations of hypothyroidism
and PKU screening program, and the importance of these diseases in a national scale, this
study resulted in design of hypothyroidism and PKU screening software for infants in Isfahan
province. The inputs and outputs of the software were designed in three levels including
Health Care Centers in charge of the screening program, provincial reference lab, and health
and treatment network of Isfahan province. Immediate registration of sample data at the time
and location of sampling, providing the provincial reference Laboratory and Health Centers of
different eparchies with the ability to instantly observe, monitor, and follow‑up on the samples
at any moment, online verification of samples by reference lab, creating a daily schedule for
reference lab, and receiving of the results from analysis equipment; and entering the results
into the database without the need for user input are among the features of this software.
Conclusion: The implementation of hypothyroidism screening software led to an increase in
the quality and efficiency of the screening program; minimized the risk of human error in the
process and solved many of the previous limitations of the screening program which were
the main goals for implementation of this software. The implementation of this software also
resulted in improvement in precision and quality of services provided for these two diseases
and better accuracy and precision for data
inputs by providing the possibility of entering
the sample data at the place and time of
sampling which then resulted in the possibilityof management based on precise data and also helped develop a comprehensive database
and improved the satisfaction of service recipients.

Keywords

1. Brown RS, Demmer LA. The etiology of thyroid dysgenesis‑still
an enigma after all these years. J Clin Endocrinol Metab
2002;87:4069‑71.2. Klett M. Epidemiology of congenital hypothyroidism. Exp Clin
Endocrinol Diabetes 1997;105 Suppl 4:19‑23.
3. Albert BB, Cutfield WS, Webster D, Carll J, Derraik JG, Jefferies C,
et al. Etiology of increasing incidence of congenital hypothyroidism
in New Zealand from 1993‑2010. J Clin Endocrinol Metab
2012;97:3155‑60.
4. Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet
J Rare Dis 2010;5:17.
5. Ordookhani A, Mirmiran P, Hedayati M, Hajipour R, Azizi F.
Screening for congenital hypothyroidism in Tehran and Damavand:
An interim report on descriptive and etiologic findings, 1998‑2001.
Iran J Endocrinol Metab 2002;4:153‑60.
6. Hashemipour M, Taghavi A, Mosayyebi Z, Dana MK, Amini M,
Iranpour R, et al. Screening for congenital hypothyroidism in
Kashan, Iran. J Mazandaran Univ Med Sci 2005;14:83‑91.
7. Hashemipour M, Iranpour R, Amini M, Hovsepian S, Haghighi S.
Comparison of the recall rate using two different diagnostic criteria
at Isfahan screening program for congenital hypothyroidism.
J Rafsanjan Univ Med Sci 2004;3:134‑40.
8. Akha O, Shabani M, Kosaryan M, Ghafari V, Saravi SS. Prevalence
of congenital hypothyroidism in Mazandaran province, Iran, 2008.
J Mazandaran Univ Med Sci 2011;21:72‑9.
9. Kumorowicz‑Czoch M, Tylek‑Lemanska D, Starzyk J. Thyroid
dysfunctions in children detected in mass screening for congenital
hypothyroidism. J Pediatr Endocrinol Metab 2011;24:141‑5.
10. Harris KB, Pass KA. Increase in congenital hypothyroidism in
New York State and in the United States. Mol Genet Metab
2007;91:268‑77.
11. Fisher DA. Effectiveness of newborn screening programs for
congenital hypothyroidism: Prevalence of missed cases. Pediatr
Clin North Am 1987;34:881‑90.
12. Beardsall K, Ogilvy‑Stuart AL. Congenital hypothyroidism. Curr
Paediatr 2004;14:422‑9.
13. Delavari A, Yar Ahmadi SH, Birjandi R, Mahdavi A, Norouzinejad A,
Dini M. Cost benefit analysis of the neonatal screening program
implementation for the CH in IR of Iran. JEndocrinol Metab 2006;4:84‑7.