Routine laboratory screening for children entering foster care may be costly given the low diagnostic yield, according to a study published in the December issue of Pediatrics. The authors suggest that targeted, rather than routine, laboratory screening may be a more clinically meaningful approach to manage children entering foster care. It is estimated that more than 400,000 children are in the custody of U.S. child welfare agencies. To address concerns related to "uncoordinated or discontinuous" medical care, most states mandate children receive a physical upon entering the foster care system. In 2005, the American Academy of Pediatrics issued expert opinion-based guidance in its Healthy Foster Care America report recommending certain disease screenings through laboratory testing as part of this examination. In order to assess the utility of laboratory screenings for children entering foster care, clinical and laboratory data was examined for 1,977 children seen at a consultation foster care clinic over a three-year period in a single county in Ohio. Standard laboratory screening included testing for infectious diseases (HIV, hepatitis B and C, syphilis, and tuberculosis), and hemoglobin and lead levels. The researchers found that over the study period 16,754 laboratory screening tests were performed, with 60 percent of children […]