Macquarie University Centre for the Health Economy, Sydney, NSW, Australia.
Department of Economics and Related Studies, University of York, York, UK.
Appl Health Econ Health Policy. 2019 Jun;17(3):331-357. doi: 10.1007/s40258-018-00456-1.
Permanent childhood hearing loss is one of the most common birth conditions associated with speech and language delay. A hearing screening can result in early detection and intervention for hearing loss.
To update and expand previous systematic reviews of economic evaluations of childhood hearing screening strategies, and explore the methodological differences.
MEDLINE, Embase, the Cochrane database, National Health Services Economic Evaluation Database (NHS EED), the Health Technology Assessment (HTA) database, and Canadian Agency for Drugs and Technologies in Health's (CADTH) Grey matters.
STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS: Economic evaluations reporting costs and outcomes for both the intervention and comparator arms related to childhood hearing screening strategies.
Thirty evaluations (from 29 articles) were included for review. Several methodological issues were identified, including: few evaluations reported outcomes in terms of quality-adjusted life years (QALYs); none estimated utilities directly from surveying children; none included disutilities and costs associated with adverse events; few included costs and outcomes that differed by severity; few included long-term estimates; none considered acquired hearing loss; some did not present incremental results; and few conducted comprehensive univariate or probabilistic sensitivity analysis. Evaluations published post-2011 were more likely to report QALYs and disability-adjusted life years (DALYs) as outcome measures, include long-term treatment and productivity costs, and present incremental results.
We were unable to access the economic models and, although we employed an extensive search strategy, potentially not all relevant economic evaluations were identified.
Most economic evaluations concluded that childhood hearing screening is value for money. However, there were significant methodological limitations with the evaluations.
永久性儿童听力损失是最常见的与言语和语言延迟相关的出生缺陷之一。听力筛查可以实现听力损失的早期发现和干预。
更新和扩展之前对儿童听力筛查策略的经济性评价的系统评价，并探讨方法学差异。
MEDLINE、Embase、Cochrane 数据库、英国国家卫生服务经济评价数据库（NHS EED）、卫生技术评估（HTA）数据库和加拿大药物和技术评估机构（CADTH）灰色文献。
研究入选标准、参与者和干预措施：经济评价报告与儿童听力筛查策略相关的干预组和对照组的成本和结果。
共纳入 30 项评价（来自 29 篇文章）进行综述。确定了几个方法学问题，包括：很少有评价以质量调整生命年（QALYs）报告结果；没有一个直接从调查儿童中估计效用；没有一个包括与不良事件相关的非效用和成本；很少有包括按严重程度划分的成本和结果；很少有包括长期估计数；没有一个考虑获得性听力损失；有些没有呈现增量结果；很少进行全面的单变量或概率敏感性分析。2011 年后发表的评价更有可能报告 QALYs 和残疾调整生命年（DALYs）作为结果测量指标，包括长期治疗和生产力成本，并呈现增量结果。
我们无法获取经济模型，尽管我们采用了广泛的搜索策略，但可能仍有一些相关的经济评价未被发现。
大多数经济评价都认为儿童听力筛查是物有所值的。然而，这些评价存在着显著的方法学局限性。
