Cuzin B, Perez-Niddam K, Truy E, Maisonnneuve H; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2000; 16: 350.
Agence Nationale d'Accreditation et d'Evaluation en Sante (ANAES), Paris, France; Hopital E Herriot, Lyon, France
Objective: Prevalence estimates for severe congenital and prelingual hearing impairment range from 1 to 3/1000 live birth in European countries. They are higher than for other neonatal afflictions for which screening has already been set up, ANAES appraised whether mass screening of PCHI with otoacoustic emissions (OEA) would be justified. Method: ANAES analysed whether the principles and prerequisites defined by the World Health Organisation (WHO) (Wilson & Junger, 1968) for initiating a mass screening programme were met for PCHI. Aspects to be considered were: epidemiology, diagnosis, therapy and the economic cost of screening tests and treatment. ANAES performed a critical review of the medical and economic literature on PCHI(MEDLINE, Embase, HealthSTAR, Pascal; 1990-1998) and convened a 13-member panel comprising specialists (audiologists, paediatricians, physiologists, geneticists), a general practitioner and a bioengineer for their expert opinion. Results: Testing by OEA is associated with a very high rate of false positives and some failure of testability necessitating retesting. Measuring the auditory brainstem response (ABR) is a good alternative test but takes longer than OEA even though the latest ABR equipment (algo II) could work faster. Other available tests cannot be used for neonatal screening. The cost of detecting a child with PCHI by OEA is acceptable compared to the per child costs of other neonatal screening programmes already set up in France. However, no cost-effectiveness study has compares the costs of using OEA as a screening test as compared to a diagnostic test. Several treatments for hearing loss have shown clear benefits, But no clinical trials have evaluated the effects of early screening on long-term functional outcomes and quality of life. Conclusions: Screening for PCHI before the age of six months could be recommended in France on the basis of available epidemiological data and of evidence on the effectiveness of early detection. However, the best screening strategy would have to be clearly defined. In the USA, a balanced number of screening programs has chosen either OEA or ABR as a first screening test. ANAES had recommended that pilot studied of PCHI screening be set up at a regional level to define the best mass screening strategy for France, taking into account organisational aspects.
Publication Types:
Keywords:
- Child
- Cost-Benefit Analysis
- Evoked Potentials, Auditory, Brain Stem
- Female
- France
- Hearing Loss
- Humans
- Infant, Newborn
- Live Birth
- Mass Screening
- Neonatal Screening
- Otoacoustic Emissions, Spontaneous
- Pregnancy
- Prevalence
- United States
- economics
- hsrmtgs
Other ID:
UI: 102271757
From Meeting Abstracts