Context

Albert Einstein defined insanity as “doing the same thing over and over again and expecting different results”. Such is the state of detecting congenital heart defects (CHD) in newborns. For years, clinicians have been taught that a careful physical examination of the newborn can detect CHD while witnessing cases of failed detection of newborns with critical CHD (CCHD). Despite these failures, we never critically addressed our strategy. The recent study by Ewer et al on the accuracy of pulse oximetry as a screening tool for CHD adds more credence to a new strategy to improve detection.