Both the findings comply to a sequential screening practice where second trimester MSS is only performed after a normal measurement of NT in the first trimester.
This program does not comply to any evaluation criteria of screening programs and its cost efficacy ratio is very poor.
There are reports of increasing reliance on restrictive or coercive means to achieve public health goals, such as legislation passed in Russia to detain individuals for up to six months who fail to comply with screening, diagnosis and treatment [ 34].
The reasons for failing to comply with screening invitation confirmed what was already known for Italy: opportunistic screening outside screening programmes is very widespread and logistical barriers interfere with compliance (lack of time, failure to receive the letter).
The significantly higher detection rate in hospitals complying with screening guidelines for child abuse (0.3%) compared to those not complying (0.1%) shows the importance of increased situational awareness for improving detection of child abuse.
The χ test was used to compare baseline categorical variables between hospitals complying and not complying with screening policy, between cases screened and not screened for child abuse, and between children with and without suspected abuse.
Medical practitioner recommendation can increase the likelihood of complying with CRC screening up to 23-times [ 29, 30], with over 75% of persons reporting that they would undertake screening if it were recommended by a doctor [ 31, 32].
The detection rate of suspected child abuse was higher in emergency departments complying than not complying with screening guidelines.
The rate of suspected child abuse was higher in hospitals complying versus hospitals not complying with screening guidelines (0.3% vs 0.1%, p<0.001) (table 1).
This study examines the detection rates of suspected child abuse in the emergency departments of seven Dutch hospitals complying and not complying with screening guidelines for child abuse.
In hospitals complying with screening guidelines for child abuse, the detection rate was higher (0.3%) than in those not complying (0.1%, p<0.001).
