NICHD requested the Committee on National Statistics of the National Research Council (NRC), in collaboration with the Board on Children, Youth, and Families of the NRC and the Institute of Medicine (IOM) and the IOM Board on Population Health and Public Health Practice, to conduct a review of the research plan for the NCS. The purpose of the review is to assess the scientific rigor of the NCS and the extent to which it is being carried out with methods, measures, and collection of data and specimens to maximize the scientific yield of the study.

The panel concludes that the NCS offers an excellent opportunity to examine the effects of environmental influences on child health and development, as well as to explore the complex interactions between genes and environments. If the NCS is conducted as proposed, the database derived from the study should be valuable for investigating hypotheses described in the research plan as well as additional hypotheses that will evolve. Nevertheless, there are important weaknesses and shortcomings in the research plan that diminish the study’s expected value below what it might be. This Executive Summary provides a brief overview of our assessment of the study’s strengths and weaknesses; the box at the end of this summary lists the panel’s recommendations for improvements to the study. Although we recognize that their implementation may raise issues of added cost and response burden, we urge that they receive serious consideration.

STRENGTHS

If the NCS is conducted as proposed, its strengths would include:

  1. Responsiveness to the Children’s Health Act of 2000 The stated goals for the NCS, and the design of the NCS for achieving those goals, broadly reflect the stipulations of the Children’s Health Act.

  2. The large number of births to be included 100,000 births would provide enough statistical power to examine many hypothesized relations that cannot be investigated with smaller samples.

  3. The longitudinal design stretching from before birth until age 21 A data set that contains data gathered prospectively over the entire course of pregnancy, childhood, adolescence, and early adulthood will enable many new life-cycle relations between exposures and outcomes to be investigated. Data gathered prospectively (or with relatively short retrospective periods) should be more precise than data that are based on long periods of recall. A particularly attractive feature of the study is the effort to recruit births before conception and during very early periods of gestation, when certain environmental exposures may prove to be critically important.

  4. The many variables to be generated on both outcomes and exposures The enormous array of social, psychological, biological, chemical, and



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