Urgency categories in BRIDGES-NBS
| Urgency category | Recommendation | Clinical rationale | Representative examples |
|---|---|---|---|
| 1. Urgent evaluation regardless of symptoms | Primary care or specialist evaluation recommended within 1-2 days, even if the infant appears well. | Affected infants may develop acute illness or sudden decompensation before symptoms are readily apparent, or sustain irreversible harm if treatment is delayed. Prompt assessment is needed to identify disease manifestations and initiate treatment or protective measures. |
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| 2. Urgency determined by symptoms |
If symptomatic: Primary care or specialist evaluation recommended within 1-2 days. If asymptomatic: Specialist evaluation recommended within 2-6 weeks. |
Concerning signs or symptoms may indicate active disease requiring rapid assessment and treatment. Infants without concerning symptoms should undergo scheduled specialist evaluation to clarify disease status and guide management. |
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| 3. Expedited evaluation for a specific time-sensitive intervention | Specialist evaluation recommended within 1-2 weeks. | Affected infants are not expected to develop acute illness or sudden decompensation. However, prompt initiation of a specific time-sensitive treatment may be needed to reduce complications or prevent irreversible morbidity. |
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| 4. Prompt specialist evaluation | Specialist recommended within 2-6 weeks. | Further evaluation requires condition-specific expertise to establish disease status, characterize manifestations, and determine the need for treatment or surveillance. |
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| 5. Prompt primary care evaluation | Primary care evaluation recommended within 2-6 weeks, which may be at the infant’s next well-child check. | Primary care clinicians can initiate evaluation, provide anticipatory guidance and preventive counseling, and coordinate condition-specific testing. Additional specialist referrals are guided by the findings and the infant’s and family’s care needs. |
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