87,913 research outputs found

    OPPORTUNITY ANALYSIS OF NEWBORN SCREENING PROGRAMS

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    There exist congenital diseases that reduce newborns' potential opportunities. This reduction is sometimes alleviated if the congenital disease is early detected thanks to a newborn screening program. We propose an outcome measurement of newborn screening programs based on the opportunity gains they offer after its implementation. We show that, under plausible assumptions, preferences among the available screening programs for a particular disease according to this new outcome measurement, do not depend on the metric of opportunity. We also apply our model to the current debate about choosing between a selective or a universal newborn hearing screening program to detect congenital hearing impairment.Opportunity analysis, potential success, screening programs

    Opportunity analysis of newborn screening programs

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    There exist congenital diseases that reduce newborns' potential opportunities. This reduction is sometimes alleviated if the congenital disease is early detected thanks to a newborn screening program. We propose an outcome measurement of newborn screening programs based on the opportunity gains they offer. We show that, under plausible assumptions, the ranking of the available screening programs for a particular disease, according to this new outcome measurement, do not depend on the metric of opportunity. We also apply our model to the current debate about choosing between a selective or a universal newborn hearing screening program to detect congenital hearing impairment.opportunities, potential success, screening programs

    Informed choice and public health screening for children: the case of blood spot screening

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    Objective: To examine parents' and health professionals' views on informed choice in newborn blood spot screening, and assess information and communication needs. Design and participants: A qualitative study involving semi-structured telephone interviews and focus groups with 47 parents of children who were either found to be affected or unaffected by the screened conditions, and 35 health professionals with differing roles in newborn blood spot screening programmes across the UK. Results and conclusions: Parents and health professionals recognize a tension between informed choice in newborn blood spot screening and public health screening for children. Some propose resolving this tension with more information and better communication, and some with rigorous dissent procedures. This paper argues that neither extensive parent information, nor a signed dissent model adequately address this tension. Instead, clear, brief and accurate parent information and effective communication between health professionals and parents, which take into account parents' information needs, are required, if informed choice and public health screening for children are to coexist successfully

    Modelling costs and outcomes of newborn hearing screening: The economic part of a German health technology assessment project

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    The prevalence of newborn hearing disorders is 1-3 per 1000. Crucial for later outcome are correct diagnosis and effective treatment in the first year of life. With BERA and TEOAE low-risk techniques for early detection are available. Universal screening is recommended but not realised in most European health care systems. Objective of the study was to examine the scientific evidence of newborn hearing screening, thus to compare cost-effectiveness of different programmes, differentiated by type of strategy (risk screening, universal screening, no screening). Methods: In an interdisciplinary health technology assessment project all relevant studies on newborn hearing screening were identified and data on medical outcome, costs and cost-effectiveness extracted. A Markov model was designed to calculate cost-effectiveness ratios. Results: Economic data were extracted from 20 relevant publications. In the model total costs for screening of 100.000 newborns with a time horizon of ten years were calculated: 2.0 Mio . for universal screening (U), 1.0 Mio. for risk screening (R) and 0.6 Mio. for no screening (N). The costs per child detected: 13,395 (U) respectively 6,715 (R) and 4,125 (N). Conclusions: A remarkable small number of economic publications mainly of low methodo-logical quality was found. In our own model we found reasonable cost-effectiveness ratios also for universal screening. Considering the outcome advantages of higher numbers of cases detected a universal newborn hearing screening is recommended. --

    Newborn hearing screening in Hong Kong

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    OBJECTIVES. To review studies on newborn hearing screening in Hong Kong and the current evidence on the cost-effectiveness of universal newborn hearing screening programmes and to determine their value and the best model for such a programme in Hong Kong. DATA SOURCE. Medline literature search (1985-2004), local reports and abstracts available to the author. STUDY SELECTION . Literature and data on newborn hearing screening strategies, screening devices, cost-effectiveness study of universal newborn hearing screening programmes. DATA EXTRACTION. Relevant information and data were reviewed by the author. DATA SYNTHESIS. A universal newborn hearing screening programme with a high coverage rate is essential to enable early diagnosis and intervention before 6 months of age. This ensures good language and cognitive outcomes in hearing impaired children. A cost-effective universal newborn hearing screening programme should be hospital-based to achieve a high coverage rate, use modern screening devices with high sensitivity and specificity that enable early diagnosis, and be acceptable to parents. CONCLUSIONS. Increasing evidence supports the cost-effectiveness and long-term benefits of universal newborn hearing screening programmes. The medical community in Hong Kong should work towards the development and implementation of a well-coordinated, collaborative, multidisciplinary, cost-effective, and sustainable territory-wide universal newborn hearing screening programme coupled with interventions for the next generation of hearing impaired children.published_or_final_versio

    Pediatric residents\u27 use of jargon during counseling about newborn genetic screening results

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    OBJECTIVE. The goal was to investigate pediatric residents’ usage of jargon during discussions about positive newborn screening test results. METHODS. An explicit-criteria abstraction procedure was used to identify jargon usage and explanations in transcripts of encounters between residents and standardized parents of a fictitious infant found to carry cystic fibrosis or sickle cell hemoglobinopathy. Residents were recruited from a series of educational workshops on how to inform parents about positive newborn screening test results. The time lag from jargon words to explanations was measured by using “statements,” each of which contained 1 subject and 1 predicate. RESULTS. Duplicate abstraction revealed reliability K of 0.92. The average number of unique jargon words per transcript was 20; the total jargon count was 72.3 words. There was an average of 7.5 jargon explanations per transcript, but the explained/ total jargon ratio was only 0.17. When jargon was explained, the average time lag from the first usage to the explanation was 8.2 statements. CONCLUSION. The large number of jargon words and the small number of explanations suggest that physicians’ counseling about newborn screening may be too complex for some parents

    Implementing a newborn hearing screening programme : a feasibility study : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts at Massey University

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    Aim. To determine the feasibility of implementing a universal newborn hearing screening programme at National Women's Hospital (NWH), Auckland, New Zealand. Method. This feasibility study evaluates the potential for success of a Universal Newborn Hearing Screening (UNHS) Programme in a tertiary hospital setting. A review of the present provision of care for infants with congenital hearing loss and a clear description of the current environment and resources at National Women's Hospital was undertaken. By utilising the four key determinants of a feasibility study as described by Whitten, Bently & Dittman (2001) I was able to provide a clear description of the current position and explore the alternative solutions, ensuring an accurate and comprehensive study approach was undertaken. Results. A detailed analysis of the environmental setting and population at NWH identified the support required for implementing a UNHS programme. Findings also identified the acceptance by both staff and consumers in providing improved congenital hearing loss detection and intervention early in the newborn period. The evidence supported recommendations for two possible hearing screening protocols that are both practical and feasible in the National Women's Hospital setting for the detection of congenital hearing loss in the newborn population. Conclusion. Overall findings indicated that the implementation of UNHS at National Women's Hospital is feasible. The current method of detecting hearing loss in the newborn population is inadequate with unacceptable delays for diagnosis and appropriate intervention to improve outcomes for those identified with a congenital hearing loss. The protocols supported by this study are based on the research findings and are unique to the NWH environment and target population. They will ensure the infants with congenital hearing loss are detected and referred early (soon after birth) so formal audiological diagnosis and strategies for intervention can occur with treatment implemented by six months of age. This will improve the child's communication and learning skills, improving their level of education and long term learning ability. Further and regular audit of the programme, screeners and outcomes will be required to ensure its efficiency as a screening service for congenital hearing loss

    Mothers’ perspectives of newborn hearing screening programme

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    Background: Newborn hearing screening programs identifies newborns with hearing loss. The early identification enables prompt intervention through hearing rehabilitation. Accurate knowledge of the program and its benefit will impact on the uptake of the program by the citizenry. We hypothesized that there is a gap in the knowledge of parents on hearing screening and rehabilitation measures in Nigeria.Aim: To determine the knowledge and perceptions of mothers of newborn children on hearing screening.Methods: A cross sectional observational study among mothers of newborn children at immunization clinics. Semi structured questionnaire on gestational duration, mode of delivery, birth asphyxia, knowledge on hearing loss and newborn hearing screening were administered.Results: Participants were 48 mothers with age range from 18 to 42 years. Awareness of newborn hearing screening was poor among the mothers; sources of information on newborn hearing screening were antenatal clinic, mass media and friends. The educational level of the participants had no association with awareness (p = 0.11), but the willingness to accept newborn hearing screening, was associated with socioeconomic status (p = 0.04) and the level of education (p = 0.02). The participants were not aware of factors responsible for hearing loss in childhood.Conclusion: There is inadequate knowledge about newborn hearing screening and risk factors for infant hearing loss among the mothers, though they demonstrate willingness to accept the newborn hearing screening. Funding: None declaredKeywords: Hearing loss, hearing screening, immunization, mother, newbor
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