Download PDF
CC BY 4.0 · Int Arch Otorhinolaryngol
DOI: 10.1055/s-0043-1776703
Systematic Review

Cost-effectiveness of Neonatal Hearing Screening Programs: Systematic Review

Luíza Silva Vernier 
1   Department of Postgraduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
,
Carolina Pereira Fernandes 
2   Department of Speech Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
,
Pedro Pablo Skorin 
3   Department of Economics and International Relations, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
,
Audrei Thayse Viegel de Ávila 
4   Department of Speech Therapy, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
,
Daniela Centenaro Levandowski 
5   Psychology Department, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
› Author Affiliations Source of Funding The authors received no financial support for the present research.
› Further Information
   Permissions and Reprints

Abstract

Introduction Universal newborn hearing screening (UNHS) has been widely and strongly advocated as an early detection strategy for hearing loss in children. This intervention aims to prevent delays in speech and language development, which, in turn, has long-term beneficial effects on the social and emotional development and quality of life of individuals. However, the implementation of UNHS programs is circumstantial in different settings, for different reasons.

Objectives The present systematic review aimed to identify whether the implementation of UNHS programs are cost-effective, as well as their variations by localities.

Data Synthesis A search was conducted in seven databases: PubMed (Medline), Scopus, Web of Science, Embase, CINAHL, Lilacs, and Cochrane Library. Studies that included a cost analysis of UNHS programs were eligible for inclusion. Studies on evaluations of preschool or school-based programs only were excluded, among others. A total of 1,291 records were found. Of these, 23 articles were analyzed in full. All articles identified the cost-effectiveness of the UNHS programs implemented. Regarding the UNHS protocols, a wide variation was observed in all aspects: tests used, period established between tests and retests, professionals responsible for screening, environment, and criteria for defining hearing loss, limiting the generalization of this information. All studies presented values related to the expenses with the program, but none of them showed statistical elements for the described analyzes or any theoretical basis for such.

Conclusion It is necessary to estimate local specific issues, as well as the accuracy of the chosen tests and the NHS protocols used, so that more accurate analyzes on cost-effectiveness are possible.

Keywords

cost-effectiveness - hearing - neonatal screening - systematic review

Contributions of the Authors

Vernier L. S.: launch of the project, search algorithm, data extraction, data analysis, writing and manuscript editing; Fernandes C. P.: search algorithm, data extraction, data analysis; Skorin P. P.: data extraction, data analysis; Ávila A. T. V.: data extraction, data analysis; Levandowski D. C.: launch of the project, data analysis, critical editing of the manuscript for intellectual content.


Sponsorships

None.


Supplementary Material



Publication History

Received: 10 March 2023

Accepted: 15 August 2023

Article published online:
09 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Wilson BS, Tucci DL, Merson MH, O'Donoghue GM. Global hearing health care: new findings and perspectives. Lancet 2017; 390 (10111): 2503-2515
    CrossrefPubMedGoogle Scholar
  • 2 World Health Organization. Prevention of blindness and deafness: estimates [Internet]. Geneva: World Health Organization; 2015. . Available at: http://www.who.int/pbd/deafness/estimates/en/
    Google Scholar
  • 3 Bussé AML, Hoeve HLJ, Nasserinejad K, Mackey AR, Simonsz HJ, Goedegebure A. Prevalence of permanent neonatal hearing impairment: systematic review and Bayesian meta-analysis. Int J Audiol 2020; 59 (06) 475-485
    CrossrefPubMedGoogle Scholar
  • 4 Lawrensia S, Pomar EG. Newborn Hearing Screening. 2020 Aug 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; ; 2021 Jan–. PMID: 32809765
    Google Scholar
  • 5 World Health Organization. Global Costs of Unaddressed Hearing Loss and Cost-effectiveness of Interventions: A WHO Report, 2017. Geneva, Switzerland: World Health Organization; 2017
    Google Scholar
  • 6 Joint Committee on Infant Hearing. Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. J Early Hear Detect Interv 2019; 4: 1-44
    CrossrefGoogle Scholar
  • 7 Gallus R, Rizzo D, De Luca LM. et al. Does the involvement of first-year residents have a negative impact on the performance of a newborn hearing screening program?. Int J Pediatr Otorhinolaryngol 2020; 138: 110270
    CrossrefPubMedGoogle Scholar
  • 8 Kanji A, Khoza-Shangase K, Moroe N. Newborn hearing screening protocols and their outcomes: A systematic review. Int J Pediatr Otorhinolaryngol 2018; 115: 104-109
    CrossrefPubMedGoogle Scholar
  • 9 Wilson BS, Tucci DL, O'Donoghue GM, Merson MH, Frankish H. A Lancet Commission to address the global burden of hearing loss. Lancet 2019; 393 (10186): 2106-2108
    CrossrefPubMedGoogle Scholar
  • 10 World Health Organization. Newborn and infant hearing screening: current issues and guiding principles [Internet]. Geneva: World Health Organization; 2009. . Available at: http://www.who.int/blindness/publications/Newborn_and_Infant_Hearing_Screening_Report.pdf
    Google Scholar
  • 11 Kamenov K, Chadha S. Methodological quality of clinical guidelines for universal newborn hearing screening. Dev Med Child Neurol 2021; 63 (01) 16-21
    CrossrefPubMedGoogle Scholar
  • 12 Tricco AC, Lillie E, Zarin W. et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med 2018; 169 (07) 467-473
    CrossrefPubMedGoogle Scholar
  • 13 Page MJ, Moher D, Bossuyt PM. et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 2021; 372: n160
    CrossrefPubMedGoogle Scholar
  • 14 International Monetary Fund [Internet]. Available at: https://www.imf.org/external/datamapper/PPPEX@WEO/OEMDC/ADVEC/WEOWORLD/DA/IND?year=2003
    Google Scholar
  • 15 Economic Research. Federal Reserve Bank of St. Louis [Internet]. Available at: https://fred.stlouisfed.org/
    Google Scholar
  • 16 Husereau D, Drummond M, Petrou S. et al; CHEERS Task Force. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. BMJ 2013; 346: f1049
    CrossrefPubMedGoogle Scholar
  • 17 Chen X, Yuan M, Lu J, Zhang Q, Sun M, Chang F. Assessment of universal newborn hearing screening and intervention in shanghai, china. Int J Technol Assess Health Care 2017; 33 (02) 206-214
    CrossrefPubMedGoogle Scholar
  • 18 Wong LY, Espinoza F, Alvarez KM, Molter D, Saunders JE. Otoacoustic Emissions in Rural Nicaragua: Cost Analysis and Implications for Newborn Hearing Screening. Otolaryngol Head Neck Surg 2017; 156 (05) 877-885
    CrossrefPubMedGoogle Scholar
  • 19 Gupta S, Sah S, Som T. et al. Challenges of Implementing Universal Newborn Hearing Screening at a Tertiary Care Centre from India. Indian J Pediatr 2015; 82 (08) 688-693
    CrossrefPubMedGoogle Scholar
  • 20 Bevilacqua MC, Alvarenga KdeF, Costa OA, Moret AL. The universal newborn hearing screening in Brazil: from identification to intervention. Int J Pediatr Otorhinolaryngol 2010; 74 (05) 510-515
    CrossrefPubMedGoogle Scholar
  • 21 Mezzano P, Serra G, Calevo MG. STERN Group. Cost analysis of an Italian neonatal hearing screening programme. J Matern Fetal Neonatal Med 2009; 22 (09) 806-811
    CrossrefPubMedGoogle Scholar
  • 22 Olusanya BO, Emokpae A, Renner JK, Wirz SL. Costs and performance of early hearing detection programmes in Lagos, Nigeria. Trans R Soc Trop Med Hyg 2009; 103 (02) 179-186
    CrossrefPubMedGoogle Scholar
  • 23 Ciorba A, Hatzopoulos S, Busi M, Guerrini P, Petruccelli J, Martini A. The universal newborn hearing screening program at the University Hospital of Ferrara: focus on costs and software solutions. Int J Pediatr Otorhinolaryngol 2008; 72 (06) 807-816
    CrossrefPubMedGoogle Scholar
  • 24 Cao-Nguyen MH, Kos MI, Guyot JP. Benefits and costs of universal hearing screening programme. Int J Pediatr Otorhinolaryngol 2007; 71 (10) 1591-1595
    CrossrefPubMedGoogle Scholar
  • 25 Lin HC, Shu MT, Lee KS. et al. Comparison of hearing screening programs between one step with transient evoked otoacoustic emissions (TEOAE) and two steps with TEOAE and automated auditory brainstem response. Laryngoscope 2005; 115 (11) 1957-1962
    CrossrefPubMedGoogle Scholar
  • 26 Connolly JL, Carron JD, Roark SD. Universal newborn hearing screening: are we achieving the Joint Committee on Infant Hearing (JCIH) objectives?. Laryngoscope 2005; 115 (02) 232-236
    CrossrefPubMedGoogle Scholar
  • 27 Messner AH, Price M, Kwast K, Gallagher K, Forte J. Volunteer-based universal newborn hearing screening program. Int J Pediatr Otorhinolaryngol 2001; 60 (02) 123-130
    CrossrefPubMedGoogle Scholar
  • 28 Gorga MP, Preissler K, Simmons J, Walker L, Hoover B. Some issues relevant to establishing a universal newborn hearing screening program. J Am Acad Audiol 2001; 12 (02) 101-112
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Isaacson G. Universal newborn hearing screening in an inner-city, managed care environment. Laryngoscope 2000; 110 (06) 881-894
    CrossrefPubMedGoogle Scholar
  • 30 Kanne TJ, Schaefer L, Perkins JA. Potential pitfalls of initiating a newborn hearing screening program. Arch Otolaryngol Head Neck Surg 1999; 125 (01) 28-32
    CrossrefPubMedGoogle Scholar
  • 31 Bantock HM, Croxson S. Universal hearing screening using transient otoacoustic emissions in a community health clinic. Arch Dis Child 1998; 78 (03) 249-252
    CrossrefPubMedGoogle Scholar
  • 32 Mason JA, Herrmann KR. Universal infant hearing screening by automated auditory brainstem response measurement. Pediatrics 1998; 101 (02) 221-228
    CrossrefPubMedGoogle Scholar
  • 33 Weirather YP, Korth N, White KR, Downs D, Woods-Kershner N. Cost analysis of TEOAE-based universal newborn hearing screening. J Commun Disord 1997; 30 (06) 477-492 , quiz 492–493
    CrossrefPubMedGoogle Scholar
  • 34 Barsky-Firkser L, Sun S. Universal newborn hearing screenings: a three-year experience. Pediatrics 1997; 99 (06) E4
    CrossrefPubMedGoogle Scholar
  • 35 Watkin PM. Neonatal otoacoustic emission screening and the identification of deafness. Arch Dis Child Fetal Neonatal Ed 1996; 74 (01) F16-F25
    CrossrefPubMedGoogle Scholar
  • 36 Maxon AB, White KR, Behrens TR, Vohr BR. Referral rates and cost efficiency in a universal newborn hearing screening program using transient evoked otoacoustic emissions. J Am Acad Audiol 1995; 6 (04) 271-277
    PubMedGoogle Scholar
  • 37 Abdul Hadi K, Salahaldin A, Al Qahtani A. et al. Universal neonatal hearing screening: Six years of experience in Qatar. Qatar Med J 2013; 2012 (02) 42-50
    PubMedGoogle Scholar
  • 38 Khandekar R, Khabori M, Jaffer Mohammed A, Gupta R. Neonatal screening for hearing impairment–The Oman experience. Int J Pediatr Otorhinolaryngol 2006; 70 (04) 663-670
    CrossrefPubMedGoogle Scholar
  • 39 González de Aledo Linos A, Bonilla Miera C, Morales Angulo C, Gómez Da Casa F, Barrasa Benito J. Cribado universal de la hipoacusia congénita en Cantabria: resultados de los dos primeros años. [Universal newborn hearing screening in Cantabria (Spain): results of the first two years] An Pediatr (Barc) 2005; 62 (02) 135-140
    CrossrefPubMedGoogle Scholar
  • 40 Verkleij ML, Heijnsdijk EAM, Bussé AML. et al; Country-Committees Joint-Partnership of EUSCREEN Study Consortium. Cost-Effectiveness of Neonatal Hearing Screening Programs: A Micro-Simulation Modeling Analysis. Ear Hear 2021; 42 (04) 909-916
    CrossrefPubMedGoogle Scholar
  • 41 Mackey AR, Bussé AML, Hoeve HLJ. et al. EUS€REEN Foundation. Assessment of hearing screening programmes across 47 countries or regions II: coverage, referral, follow-up and detection rates from newborn hearing screening. Int J Audiol 2021; 9: 1-10
    Google Scholar