A programme of studies including assessment of diagnostic accuracy of school hearing screening tests and a cost-effectiveness model of school entry hearing screening programmes
| Autor: | Heather Fortnum, Obioha C Ukoumunne, Chris Hyde, Rod S Taylor, Mara Ozolins, Sam Errington, Zhivko Zhelev, Clive Pritchard, Claire Benton, Joanne Moody, Laura Cocking, Julian Watson, Sarah Roberts |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: | |
| Zdroj: | Health Technology Assessment, Vol 20, Iss 36 (2016) |
| Druh dokumentu: | article |
| ISSN: | 1366-5278 2046-4924 |
| DOI: | 10.3310/hta20360 |
| Popis: | Background: Identification of permanent hearing impairment at the earliest possible age is crucial to maximise the development of speech and language. Universal newborn hearing screening identifies the majority of the 1 in 1000 children born with a hearing impairment, but later onset can occur at any time and there is no optimum time for further screening. A universal but non-standardised school entry screening (SES) programme is in place in many parts of the UK but its value is questioned. Objectives: To evaluate the diagnostic accuracy of hearing screening tests and the cost-effectiveness of the SES programme in the UK. Design: Systematic review, case–control diagnostic accuracy study, comparison of routinely collected data for services with and without a SES programme, parental questionnaires, observation of practical implementation and cost-effectiveness modelling. Setting: Second- and third-tier audiology services; community. Participants: Children aged 4–6 years and their parents. Main outcome measures: Diagnostic accuracy of two hearing screening devices, referral rate and source, yield, age at referral and cost per quality-adjusted life-year. Results: The review of diagnostic accuracy studies concluded that research to date demonstrates marked variability in the design, methodological quality and results. The pure-tone screen (PTS) (Amplivox, Eynsham, UK) and HearCheck (HC) screener (Siemens, Frimley, UK) devices had high sensitivity (PTS ≥ 89%, HC ≥ 83%) and specificity (PTS ≥ 78%, HC ≥ 83%) for identifying hearing impairment. The rate of referral for hearing problems was 36% lower with SES (Nottingham) relative to no SES (Cambridge) [rate ratio 0.64, 95% confidence interval (CI) 0.59 to 0.69; p |
| Databáze: | Directory of Open Access Journals |
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