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                         We are looking into the feasibility of changing
| over to to TANDEM MASS SPECTROMETRY as our method of Newborn Screening.
| 
|              Our current workload is 150000 samples per year. These are
| currently screened for Phenylalanine and TSH.
| 
| We should like to ask  advice on the following points.
| 
| How many instruments would we need to run such a program?
| What is the reliability of the technology? How much down time could we
| expect from our instrument?
| 
| 	Excluding salaries and the initial costs of purchasing such an
| instrument/s what is the cost per test? 
| 
| How many people are need to run such an operation and at what level of
| skill.
| 
| How good is the current software available to run the system. To what
| extent can it be automated?
| 
| What instrument would you suggest that we buy?
| What is the technical backup like on the instrument?
| Are the manufacturer's capable of helping us to properly set up the
system
| and keep it running?
| 
| I would be interested in obtaining a copy of the protocol.
| 
| Have there been any studies that have looked at a cost-benefit analysis
of
| conversion to this method?
| 
| Why has this not yet obtained FDA approval in the US.

As far as the number of new cases is concerned we feel that for certain we
would find many. We have a very diverse population here with high levels of
consanguinity in certain groups.

I should be interested in advice on this subject.

| JOSEPH ZLOTNIK.
| The Institute of Chemical Pathology,
  The Chaim Sheba Medical Center,
   TEL HASHOMER 52621 ISRAEL.
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