Original Title: Programa de cribado de hipoacusia neonatal: revisión sistemática de estudios de evaluación económica y análisis descriptivo de los programas de las CC.AA

Authors' objectives: The aim of this document is to provide the information necessary for decision making to advance in the specification and standardisation of neonatal hearing screening programmes in Spain. The specific objectives are: 1. to review the economic evidence of the different strategies used for the detection of neonatal hearing in the population screening of neonatal hearing. 2. to analyse the various different protocols used in neonatal hearing screening programmes in autonomous regions and cities in Spain.

Authors' results and conclusions: The systematic search retrieved two papers on economic assessments for analysis according to the established inclusion criteria. Critical reading of these papers concluded that they were of moderate quality, mainly due to weaknesses identified in terms of internal and external validity and in the section regarding conflicts of interest. These two studies indicate that, in the long term, population neonatal hearing screening both using automated auditory brainstem responses (AABRs) and otoacoustic emissions (OAEs) is dominant (less expensive and more effective) than not screening (ICER = –$4,545.45/QALY and ICER = –$6,309.52/QALY, for AABRs and OAEs, respectively) and that population neonatal hearing screening is more cost effective using AABRs than using OAEs (ICER = $3,393/QALY assuming a willingness to pay threshold of $20,000/QALY). Further, in the short term, population neonatal hearing screening using AABRs is dominant over population hearing screening using OAEs (incremental cost = $103,100 and incremental effectiveness = hearing loss detected in 3,850 neonates). From the descriptive analysis of the early detection programmes for hypoacusis, we are able to deduce that in the 17 autonomous regions and the two autonomous cities early detection of neonatal hearing loss is performed through population screening, and that in 9 cases, there is selective screening of neonates with high-risk factors, using OAE, AABR and auditory brainstem response testing, and one, two or three exploratory phases, before referring neonates with suspected hearing loss for diagnosis. In terms of the organisational characteristics, there are three elements that are common to most regions that carry out universal neonatal hearing screening: early detection tests for hearing loss is carried out before hospital discharge, in the maternity units of the hospitals and mainly by the neonatal nursing staff. CONCLUSION The economic evaluations included in the systematic review suggest that population screening for neonatal hearing is cost-effective versus non-screening and whether population neonatal hearing screening using AABRs is more cost-effective than that using OAEs. The descriptive analysis of the neonatal screening programmes of the autonomous regions does not allow us to establish common elements in terms of the general design or organisational characteristics, given the heterogeneity observed. The information provided by the different programmes is variable and it does not provide sufficient data for informed decision making.

Authors' methods: First, the websites of the main agencies for healthcare technology assessment were consulted seeking to identify reports on the subject of interest. Secondly, starting from this base of information, a systematic review was conducted of economic assessment studies, searching databases of economic and medical literature. In addition, a search was conducted through the websites of the councils or departments of healthcare or health in each of the regions seeking to identify the universal neonatal hearing screening programmes implemented there. The head of the Screening Programme Unit at the Subdirectorate General for Health Promotion and Vigilance, in the Public Health section of the Ministry of Health, Consumer affairs and Social wellbeing was contacted for the data retrieved in the aforementioned search to be checked by people responsible for the programmes in each region/city. Once the data had been checked, a descriptive analysis of each programme was conducted, considering its general design and also how it is organised.

Project Status: Completed

Year Published: 2020

URL for published report: https://www.euskadi.eus/web01-a2aznscp/es/k75aWebPublicacionesWar/k75aObtenerPublicacionDigitalServlet?R01HNoPortal=true&N_LIBR=052572&N_EDIC=0001&C_IDIOM=es&FORMATO=.pdf

English language abstract: An English language summary is available

Publication Type: Other

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government</p>