Congenital heart disease is one of several ailments, including pneumonia and sepsis, that kill eight babies every minute, every day. But a decades-old technology, combined with a smartphone app, can tell doctors in less than 60 seconds if a baby is at risk for any of these asymptomatic, hard-to-detect killers. And in developing nations like China, it costs less than a diaper change.
There’s some controversy in pediatrics about the utility of the oxygen saturation screening for congenital heart disease. There are a lot of false positives and a lot of the most common types of congenital heart defects don’t result in oxygen saturation problems. There are a lot of issues with doing this in places in the U.S. without easy access to pediatric cardiologists and echocardiography, where the false positives make it harder for kids with real issues to get seen and treated.
Expanding this into resource poor nations is a waste. What good is a positive screen if you don’t have available echo techs, cardiologists, and cardiothoracic surgeons? It’s only a chance at a long life if you can do something about a positive screen. For example hypoplastic left heart syndrome, one of the conditions we’re screening for, requires three complex surgeries over the first 3 years of life, months of cardiac ICU time, a really good multidisciplinary team, and is ultimately just palliative and usually ends up with a heart transplant in the teens or early twenties. So what’s the utility of screening for this in a country that is struggling to provide basic clean water and manage diseases that cost pennies to prevent or treat?