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Rationale: Cystic fibrosis (CF) newborn screening (NBS) algorithms in the United States vary by state. Differences in CF NBS algorithms could potentially affect the detection rate of CF newborns and lead to disparities in CF diagnosis amongst different racial and ethnic groups., Objectives: Generate a database of CF NBS algorithms in the United States and identify processes that may potentially lead to missed diagnoses or lead to healthcare disparities., Methods: We sent an online survey to state and regional CF and NBS leaders about the type and threshold of immunoreactive trypsinogen (IRT) cutoff used and methods used for CFTR  gene variant analysis. Follow-up by email and phone was done to ensure a response from every state, clarify responses, and resolve discordances., Results: There is wide variation in the NBS algorithms employed by different states. Approximately half the states use a floating IRT cutoff, and half use a fixed IRT cutoff. CFTR variant analysis also varies widely, with two states analyzing only for the F508del variant and four states incorporating CFTR gene sequencing. The other states use CFTR variant panels ranging from 23 to 365 CFTR variants., Conclusions: CF NBS algorithms vary widely amongst the different states in the United States, which affects the ability of CF NBS to diagnose newborn infants with CF consistently and uniformly across the country and potentially may miss more infants with CF from minority populations. Our results identify an important area for quality improvement in CF NBS., (© 2022 Wiley Periodicals LLC.)

Computer-assisted anterior cruciate ligament (ACL) reconstruction in the United States has been used to help improve clinical outcomes and investigate tunnel placement and kinematic activity. Computer-assisted techniques were developed to improve accuracy of tunnel placement, because of concerns about the accuracy of manual tunnel placement causing revisions. Several authors have demonstrated improved tunnel location with computer assistance, although others have demonstrated little or no difference. More recently, American investigators have used computer assistance to evaluate the position and biomechanical behavior and kinematics of theoretical tunnel placement and also to assess in vitro and in vivo knee stability following ligament reconstruction. Computer assistance of anterior ligament reconstruction has demonstrated its value as a research and clinical tool in the United States.