Abstract
Objective
Universal newborn hearing screening for bilateral permanent congenital hearing impairment
is standard practice in many developed economies, but until there is clear evidence
of cost-effectiveness, it remains a controversial use of limited health care resources.
We conducted a formal systematic review of studies of newborn hearing screening that
considered both costs and outcomes to produce a summary of the available evidence
and to determine whether there was a need for further research.
Methods
A search was conducted of medical and nursing databases and gray literature websites
by the use of multiple keywords. The titles and abstracts of studies were examined
for preliminary inclusion if reference was made to newborn hearing screening, and
to both costs and outcomes. Studies of potential relevance were independently assessed
by 2 health economists for final inclusion in the review. Studies that met inclusion
criteria were appraised by the use of existing guidelines for observational studies,
economic evaluations and decision analytic models, and reported in a narrative literature
review.
Results
There were 22 distinct observational or modeled evaluations of which only 2 clearly
compared universal newborn hearing screening to risk factor screening for bilateral
permanent congenital hearing impairment. Of these, the single evaluation that examined
long-term costs and outcomes found that universal newborn hearing screening could
be cost-saving if early intervention led to a substantial reduction in future treatment
costs and productivity losses.
Conclusions
There are only a small number of economic evaluations that have examined the long-term
cost-effectiveness of universal newborn hearing screening. This is partly attributable
to ongoing uncertainty about the benefits gained from the early detection and treatment
of bilateral permanent congenital hearing impairment. There is a clear need for further
research on long-term costs and outcomes to establish the cost-effectiveness of universal
newborn hearing screening in relation to other approaches to screening, and to establish
whether it is a good long term investment.
Keywords
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Article Info
Publication History
Accepted:
February 18,
2012
Received:
November 23,
2011
Identification
Copyright
© 2012 Academic Pediatric Association. Published by Elsevier Inc. Published by Elsevier Inc. All rights reserved.
