Document Detail


Pulse oximetry as a screening test for congenital heart defects in newborn infants: a cost-effectiveness analysis.
MedLine Citation:
PMID:  22247242     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To undertake a cost-effectiveness analysis that compares pulse oximetry as an adjunct to clinical examination with clinical examination alone in newborn screening for congenital heart defects (CHDs).
DESIGN: Model-based economic evaluation using accuracy and cost data from a primary study supplemented from published sources taking an NHS perspective.
SETTING: Six large maternity units in the UK.
PATIENTS: 20 055 newborn infants prior to discharge from hospital.
INTERVENTION: Pulse oximetry as an adjunct to clinical examination.
MAIN OUTCOME MEASURE: Cost effectiveness based on incremental cost per timely diagnosis.
RESULTS: Pulse oximetry as an adjunct to clinical examination is twice as costly but provides a timely diagnosis to almost 30 additional cases of CHD per 100 000 live births compared with a modelled strategy of clinical examination alone. The incremental cost-effectiveness ratio for this strategy compared with clinical examination alone is approximately £24 000 per case of timely diagnosis in a population in which antenatal screening for CHDs already exists. The probabilistic sensitivity analysis suggests that at a willingness-to-pay (WTP) threshold of £100 000, the probability of 'pulse oximetry as an adjunct to clinical examination' being cost effective is more than 90%. Such a WTP threshold is plausible if a newborn with timely diagnosis of a CHD gained just five quality-adjusted life years, even when treatment costs are taken into consideration.
CONCLUSION: Pulse oximetry as an adjunct to current routine practice of clinical examination alone is likely to be considered a cost-effective strategy in the light of currently accepted thresholds.
Authors:
T E Roberts; P M Barton; P E Auguste; L J Middleton; A T Furmston; A K Ewer
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2012-01-13
Journal Detail:
Title:  Archives of disease in childhood     Volume:  97     ISSN:  1468-2044     ISO Abbreviation:  Arch. Dis. Child.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-14     Completed Date:  2012-04-26     Revised Date:  2012-10-22    
Medline Journal Info:
Nlm Unique ID:  0372434     Medline TA:  Arch Dis Child     Country:  England    
Other Details:
Languages:  eng     Pagination:  221-6     Citation Subset:  AIM; IM    
Affiliation:
Health Economics Unit, School of Health and Populations Science, University of Birmingham, Birmingham, UK. t.e.roberts@bham.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Cost-Benefit Analysis
Great Britain / epidemiology
Health Care Costs / statistics & numerical data
Health Resources / utilization
Heart Defects, Congenital / diagnosis*,  economics,  epidemiology
Humans
Infant, Newborn
Models, Econometric
Neonatal Screening / economics*,  methods
Oximetry / economics*
Comments/Corrections
Comment In:
J Pediatr. 2012 Sep;161(3):569-70   [PMID:  22916982 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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