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Recognition of clinical characteristics for population‐based surveillance of fetal alcohol syndrome
Author(s) -
Andrews Jennifer G.,
Galindo Maureen K.,
Meaney F. John,
Benavides Argelia,
Mayate Linnette,
Fox Deborah,
Pettygrove Sydney,
O'Leary Leslie,
Cunniff Christopher
Publication year - 2018
Publication title -
birth defects research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.845
H-Index - 17
ISSN - 2472-1727
DOI - 10.1002/bdr2.1203
Subject(s) - medicine , documentation , fetal alcohol syndrome , medical record , family medicine , public health , population , public health surveillance , medical emergency , pediatrics , pregnancy , nursing , environmental health , genetics , computer science , biology , programming language
Background The diagnosis of fetal alcohol syndrome (FAS) rests on identification of characteristic facial, growth, and central nervous system (CNS) features. Public health surveillance of FAS depends on documentation of these characteristics. We evaluated if reporting of FAS characteristics is associated with the type of provider examining the child. Methods We analyzed cases aged 7–9 years from the Fetal Alcohol Syndrome Surveillance Network II (FASSNetII). We included cases whose surveillance records included the type of provider (qualifying provider: developmental pediatrician, geneticist, neonatologist; other physician; or other provider) who evaluated the child as well as the FAS diagnostic characteristics (facial dysmorphology, CNS impairment, and/or growth deficiency) reported by the provider. Results A total of 345 cases were eligible for this analysis. Of these, 188 (54.5%) had adequate information on type of provider. Qualifying physicians averaged more than six reported FAS characteristics while other providers averaged less than five. Qualifying physicians reported on facial characteristics and developmental delay more frequently than other providers. Also, qualifying physicians reported on all three domains of characteristics (facial, CNS, and growth) in 97% of cases while others reported all three characteristics on two thirds of cases. Conclusions Documentation in medical records during clinical evaluations for FAS is lower than optimal for cross‐provider communication and surveillance purposes. Lack of documentation limits the quality and quantity of information in records that serve as a major source of data for public health surveillance systems.