Cost-effectiveness of hearing screening in preschool children: a systematic review.

IF 2 3区医学 Q2 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

International Journal of Audiology Pub Date : 2026-08-07 DOI:10.1080/14992027.2026.2709495

Seyedeh Faezeh Fazelian, Aliakbar Fazaeli, Sara Kaveh, Hossein Hossinifard, Sajjad Dorri, Nashmil Ghadimi

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引用次数: 0

Abstract

Objective: This review synthesises economic evidence for pre-school hearing screening, a debated strategy for detecting hearing loss missed by newborn programs.

Design: Following PRISMA guidelines, A comprehensive search of the Cochrane Library, EMBASE, and PubMed was performed from database inception through March 2025. The review included full economic evaluations (cost-effectiveness analyses) reporting cost per Quality-Adjusted Life Year (QALY) or Disability-Adjusted Life Year (DALY).

Study sample: Four decision-analytic modelling studies included. The studies were from the United Kingdom, Iran, and Australia, focusing on screening children at or before primary school entry.

Results: Evidence synthesis revealed significant heterogeneity. Three studies were cost-effective, while one suggested it was not. This divergence was strongly influenced by methodological factors: the modelled time horizon, the choice of outcome metric (QALY vs. DALY), and the baseline coverage of UNHS. For instance, the Incremental Cost-Effectiveness Ratio for pure-tone screening fell from $5,814/QALY over one year to $401/QALY over an 11-year horizon.

Conclusions: The cost-effectiveness of pre-school hearing screening is highly context-dependent. Key determinants include existing UNHS infrastructure, the chosen screening technology, and the evaluation time horizon. Policymakers must consider these local factors to implement the most economically viable strategy.

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学龄前儿童听力筛查的成本效益：一项系统综述。

目的：本综述综合了学前听力筛查的经济证据，这是一种有争议的策略，用于检测新生儿计划遗漏的听力损失。设计：遵循PRISMA指南，从数据库建立到2025年3月，对Cochrane Library、EMBASE和PubMed进行了全面的检索。审查包括完整的经济评价（成本-效果分析），报告每个质量调整生命年（QALY）或残疾调整生命年（DALY）的成本。研究样本：包括四项决策分析模型研究。这些研究来自英国、伊朗和澳大利亚，重点是对小学入学或入学前的儿童进行筛查。结果：证据综合显示显著的异质性。三项研究具有成本效益，而一项研究认为没有。这种差异受到方法学因素的强烈影响：建模的时间范围、结果指标的选择（QALY vs. DALY）和UNHS的基线覆盖率。例如，纯色筛查的增量成本效益比从一年的5814美元/QALY下降到11年的401美元/QALY。结论：学前听力筛查的成本-效果高度依赖于环境。关键决定因素包括现有的卫生保健基础设施、所选择的筛选技术和评估时间范围。决策者必须考虑这些本地因素，以实施最具经济可行性的战略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Audiology 医学-耳鼻喉科学

CiteScore

4.90

自引率

14.80%

发文量

133

审稿时长

4-8 weeks

期刊介绍： International Journal of Audiology is committed to furthering development of a scientifically robust evidence base for audiology. The journal is published by the British Society of Audiology, the International Society of Audiology and the Nordic Audiological Society.