Newborn screening for all identifiable disorders with tandem mass spectrometry is cost effective: the negative case.

Tandem mass spectrometry has become increasingly popular as the preferred technology for detecting inborn errors of metabolism in newborn screening programmes. Its sensitivity and specificity for detecting numerous inborn errors has been well documented. However, there are continuing questions about whether the technology should be used to the fullest when such usage may mean detecting and reporting analytical findings that could lead to diagnosing conditions for which clinical outcome is unclear and treatment may not be needed, or treatment efficacy may not yet be proven and cost effectiveness is unlikely. As part of a friendly debate to educate conference attendees on both sides of somewhat controversial issues, these 2 papers at the conference presented some of the information supporting or questioning the cost effectiveness of full scan usage and reporting in tandem mass spectrometry newborn screening. Reported here are some of the questioning arguments.