Pulse oximetry as a screening test for congenital heart defects in newborn infants: a cost-effectiveness analysis.
Arch Dis Child
; 97(3): 221-6, 2012 Mar.
Article
em En
| MEDLINE
| ID: mdl-22247242
ABSTRACT
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 OUTCOMEMEASURE:
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Oximetria
/
Triagem Neonatal
/
Cardiopatias Congênitas
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Health_economic_evaluation
/
Prognostic_studies
/
Screening_studies
Limite:
Humans
/
Newborn
País/Região como assunto:
Europa
Idioma:
En
Revista:
Arch Dis Child
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Reino Unido