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Clinical effectiveness and cost-effectiveness of the use of the thyroxine/thyroxine-bindingglobulin ratio to detect congenital hypothyroidism of thyroidal and central origin in a neonatal screening program Clinical effectiveness and cost-effectiveness of the use of the thyroxine/thyroxine-bindingglobulin ratio to detect congenital hypothyroidism of thyroidal and central origin in a neonatal screening program Clinical effectiveness and cost-effectiveness of the use of the thyroxine/thyroxine (...) . Health technology Newborn babies were screened for congenital hypothyroidism (CH) using the following protocol. Blood samples were taken and the thyroxine (T4) measured; the T4 concentration was measured as the standard deviation (SD) relative to the daily mean. If the T4 concentration was among the lowest 20%, then the thyroid-stimulating hormone (TSH) (in microunits per millilitre of serum, microUI/mL) was measured. If the T4 concentration was in the lowest 5%, then the T4-bindingglobulin (TBG