Manual for implementation or modification of child vision and hearing screening programmes:EUSCREEN

The euscreen study aimed to compare vision and hearing screening programmes for children in all EU states by using a cost-effectiveness model. The cost-effectiveness model predicts the most cost-effective and affordable way to screen children in each country, given the local circumstances. Representatives of countries in Europe were asked to provide detailed data on the following domains: demography, the general background of screening systems, existing screening systems, coverage/attendance, tests used, follow-up/diagnosis, treatment, benefits and adverse effects. Paediatric ophthalmologists, paediatric otolaryngologists, audiologists and professionals who organise and perform screening in each country were invited to participate in the study and report on the state of screening in their country. An extensive, detailed questionnaire was developed for that purpose. Screening programmes have been tested in the county of Cluj in Romania for vision, and in three counties in Albania for hearing screening. This manual for implementation or modification of child vision and hearing screening programmes was developed by detailed tracking, and from identified requisites, facilitators and barriers. The cost-effectiveness model and this manual for implementation will assist healthcare providers and policy makers worldwide in their decisions to introduce or modify vision and hearing screening programmes, and increase effectiveness, efficiency and equity of child healthcar

Manual for implementation or modification of child vision and hearing screening programmes:EUSCREEN

The euscreen study aimed to compare vision and hearing screening programmes for children in all EU states by using a cost-effectiveness model. The cost-effectiveness model predicts the most cost-effective and affordable way to screen children in each country, given the local circumstances. Representatives of countries in Europe were asked to provide detailed data on the following domains: demography, the general background of screening systems, existing screening systems, coverage/attendance, tests used, follow-up/diagnosis, treatment, benefits and adverse effects. Paediatric ophthalmologists, paediatric otolaryngologists, audiologists and professionals who organise and perform screening in each country were invited to participate in the study and report on the state of screening in their country. An extensive, detailed questionnaire was developed for that purpose. Screening programmes have been tested in the county of Cluj in Romania for vision, and in three counties in Albania for hearing screening. This manual for implementation or modification of child vision and hearing screening programmes was developed by detailed tracking, and from identified requisites, facilitators and barriers. The cost-effectiveness model and this manual for implementation will assist healthcare providers and policy makers worldwide in their decisions to introduce or modify vision and hearing screening programmes, and increase effectiveness, efficiency and equity of child healthcar

Modelling the cost-effectiveness of a newborn hearing screening programme:Usability and pitfalls

Objective: The EUSCREEN project concerns the study of European vision and hearing screening programmes. Part of the project was the development of a cost-effectiveness model to analyse such programmes. We describe the development and usability of an online tool to enable stakeholders to design, analyse or modify a newborn hearing screening (NHS) programme. Design: Data from literature, from existing NHS programmes, and observations by users were used to develop and refine the tool. Required inputs include prevalence of the hearing impairment, test sequence and its timing, attendance, sensitivity, and specificity of each screening step. Outputs include the number of cases detected and the costs of screening and diagnostics. Study sample: Eleven NHS programmes with reliable data. Results: Three analyses are presented, exploring the effect of low attendance, number of screening steps, testing in the maternity ward, or screening at a later age, on the benefits and costs of the programme. Knowledge of the epidemiology of a staged screening programme is crucial when using the tool. Conclusions: This study presents a tool intended to aid stakeholders to design a new or analyse an existing hearing screening programme in terms of benefits and costs.</p

Inventory of current EU paediatric vision and hearing screening programmes

Background: We examined the diversity in paediatric vision and hearing screening programmes in Europe. Methods: Themes relevant for comparison of screening programmes were derived from literature and used to compile three questionnaires on vision, hearing and public-health screening. Tests used, professions involved, age and frequency of testing seem to influence sensitivity, specificity and costs most. Questionnaires were sent to ophthalmologists, orthoptists, otolaryngologists and audiologists involved in paediatric screening in all EU fullmember, candidate and associate states. Answers were cross-checked. Results: Thirty-nine countries participated; 35 have a vision screening programme, 33 a nation-wide neonatal hearing screening programme. Visual acuity (VA) is measured in 35 countries, in 71% more than once. First measurement of VA varies from three to seven years of age, but is usually before the age of five. At age three and four picture charts, including Lea Hyvarinen are used most, in children over four Tumbling-E and Snellen. As first hearing screening test otoacoustic emission (OAE) is used most in healthy neonates, and auditory brainstem response (ABR) in premature newborns. The majority of hearing testing programmes are staged; children are referred after one to four abnormal tests. Vision screening is performed mostly by paediatricians, ophthalmologists or nurses. Funding is mostly by health insurance or state. Coverage was reported as >95% in half of countries, but reporting was often not first-hand. Conclusion: Largest differences were found in VA charts used (12), professions involved in vision screening (10), number of hearing screening tests before referral (1-4) and funding sources (8)

ETAPELE PRELIMINARE PENTRU IMPLEMENTAREA SCREENING-ULUI AUDITIV GENERAL NEONATAL, ÎN ALBANIA

BACKGROUND: Delayed diagnosis and/or treatment of the hearing impairment could jeopardize the future personal and social development of affected infants. Universal newborn hearing screening is an important instrument that enables the detection of most babies born with hearing impairment, but this practice needs to meet certain criteria in order to be implementable. The EUSCREEN project in Albania offers an opportunity to determine a cost-optimized model of childhood hearing screening that could be implemented in different low-to-middle income countries. In this context, the present study focuses on describing the current state of affairs of this project in Albania. METHODS: We provide the readers with a general description of activities that have been carried out in the framework of the preparatory phase and the implementation of EUSCREEN project activities in Albania. In addition, screening tests and procedure is explained and the preliminary prevalence of hearing impairment among newborns is calculated. RESULTS: EUSCREEN project in Albania has gone through multiple meetings among local partners. It is being implemented in three socio-economically diverse districts of the country. Various theoretical and practical sessions have taken place and a large number of informative materials are produced. The screening covered about 95% of all targeted newborns in selected project sites. Conclusion: So far, the EUSCREEN project in Albania is providing valuable information about the newborn hearing screening procedures, which will be used by the international team of experts to determine a cost-optimized model of childhood hearing screening.   Keywords: Albania, EUSCREEN, hearing impairment, horizon 2020, screening.CONTEXT: &Icirc;nt&acirc;rzierea diagnosticului și/sau a tratamentului la nou-născuții cu afectări ale auzului ar putea pune &icirc;n pericol dezvoltare personală și socială viitoare a acestora. Screening-ul auditiv general pentru nou-născuți este un instrument important care permite depistarea majorității copiilor născuți cu deficiențe de auz, dar această metodă trebuie să &icirc;ndeplinească anumite criterii pentru a putea fi implementată. Proiectul EUSCREEN din Albania oferă posibilitatea de a stabili un model cost optim al screening-ului auditiv al copilului, care ar putea fi implementat &icirc;n diferite țări cu venituri mici sau medii. &Icirc;n acest context, studiul de față se concentrează pe descrierea situației actuale a acestui proiect &icirc;n Albania. METODE: Studiul oferă cititorilor o descriere generală a activităților care au fost efectuate &icirc;n cadrul fazei pregătitoare și implementarea activităților proiectului EUSCREEN &icirc;n Albania. &Icirc;n plus, sunt explicate testele și metoda de screening și este calculată prevalența afecțiunilor auditive &icirc;n r&acirc;ndul nou-născuților. Rezultate: Proiectul EUSCREEN din Albania a presupus mai multe &icirc;nt&acirc;lniri &icirc;ntre partenerii locali. Proiectul s-a implementat &icirc;n trei zone socio-economice diferite ale țării. S-au desfășurat diferite sesiuni teoretice și practice și s-a realizat un număr mare de materiale informative. Screening-ul a acoperit aproximativ 95% din totalitatea nou-născuților vizați din locurile selectate &icirc;n proiect. CONCLUZII: P&acirc;nă &icirc;n prezent, proiectul EUSCREEN din Albania a oferit informații importante despre metodele de screening auditiv la nou-născut, care vor fi utilizate de către echipa internațională de experți pentru a stabili un model optim din punct de vedere al costului pentru screening-ul auditiv al copilului. &nbsp; Cuvinte cheie: Albania, EUSCREEN, tulburări de auz, Orizont 2020,&nbsp; screenin

Manual for implementation or modification of child vision and hearing screening programmes

The EUSCREEN study aimed to compare vision and hearing screening programmes for children in all EU states by using a cost-effectiveness model. The cost-effectiveness model predicts the most cost-effective and affordable way to screen children in each country, given the local circumstances. Representatives of countries in Europe were asked to provide detailed data on the following domains: demography, the general background of screening systems, existing screening systems, coverage/attendance, tests used, follow-up/diagnosis, treatment, benefits and adverse effects. Paediatric ophthalmologists, paediatric otolaryngologists, audiologists and professionals who organise and perform screening in each country were invited to participate in the study and report on the state of screening in their country. An extensive, detailed questionnaire was developed for that purpose. Screening programmes have been tested in the county of Cluj in Romania for vision, and in three counties in Albania for hearing screening. This manual for implementation or modification of child vision and hearing screening programmes was developed by detailed tracking, and from identified requisites, facilitators and barriers. The cost-effectiveness model and this manual for implementation will assist healthcare providers and policy makers worldwide in their decisions to introduce or modify vision and hearing screening programmes, and increase effectiveness, efficiency and equity of child healthcare. This manual is an interactive, web-based document, but it can also be downloaded as a single pdf file (1.62 MB)

Development of a TOOLKIT comprising of a cost-effectiveness modelling framework and strategy plan for implementation

We developed a TOOLKIT, consisting of a web-based microsimulation model as a generic tool for policymakers, and a manual for implementation or modification of child vision and hearing screening programmes. The document describes the model which can be accessed at https://miscan.euscreen.org