Cost-Effectiveness Analysis of Pulse Oximetry Screening in the Full-Term Neonates for Diagnosis of Congenital Heart Disease: A Systematic Review

Context: Congenital heart disease (CHD) is a leading cause of mortality by birth defects with significant social and economic burden. Pulse oximetry as a safe and non-invasive screening method, and with its potential for early detection of CHD has improved neonatal health outcomes. Objectives: The aim of this study was to systematically review economic evaluation studies that compared pulse oximetry with current programs to diagnose early detection of CHD in full-term newborns. Data Sources: A systematic review was conducted according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, and related articles published from 1995 up to March 2020 were searched in different databases (MEDLINE, EMBASE, PubMed, Science Direct, Google Scholar, Scopus, NHS EED, Science Citation Index, MagIran, Cochrane Library, EconLit and SID). The articles were selected based on inclusion and exclusion criteria. Consolidated health economic evaluation reporting standards (CHEERS) statement checklist was used to qualitatively evaluate the papers. Overall, 7 articles were included in the study. Results: Timely diagnosis was considered as main effectiveness health outcome in most studies. The highest and lowest values of incremental cost-effectiveness ratio (in two-phase studies) were €139,000 and $100 per infant in the Netherlands and Colombia respectively; and (in one-phase studies) were £24,000 and £1,489 per infant both belonging to the UK. Implementing pulse oximetry method concurrent with the clinical examination is more cost-effective. The reviewed studies had been conducted in high-income and upper middle-income countries; therefore, when the results are generalizing by policy makers in different health systems, a substantial precaution approach is needed.

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Pulse oximetry could significantly enhance the early detection of critical congenital heart disease in neonatal intensive care units

Acta Paediatrica ◽

10.1111/apa.13553 ◽

2016 ◽

Vol 105 (11) ◽

Cited By ~ 8

Author(s):

Xiao‐jing Hu ◽

Qu‐ming Zhao ◽

Xiao‐jing Ma ◽

Wei‐li Yan ◽

Xiao‐ling Ge ◽

...

Keyword(s):

Congenital Heart Disease ◽

Intensive Care ◽

Heart Disease ◽

Early Detection ◽

Pulse Oximetry ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Congenital Heart ◽

Neonatal Intensive Care Units ◽

Critical Congenital Heart Disease

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Early detection of and intervention for two newborns with critical congenital heart disease using a specialized device as part of a screening system

SAGE Open Medical Case Reports ◽

10.1177/2050313x20926041 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2092604

Author(s):

René Gómez-Gutiérrez ◽

Héctor Cruz-Camino ◽

Consuelo Cantú-Reyna ◽

Adrián Martínez-Cervantes ◽

Diana Laura Vazquez-Cantu ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Early Detection ◽

Pulse Oximetry ◽

Congenital Heart ◽

Screening Program ◽

Disease Screening ◽

Therapeutic Interventions ◽

Critical Congenital Heart Disease ◽

Clinical Method

Screening for critical congenital heart disease is a clinical method used for their early detection using pulse oximetry technology. This, followed by a diagnostic confirmatory protocol, allows timely therapeutic interventions that improve the newborn’s outcome. According to Mexican birth statistics, approximately 18,000–21,000 neonates are born with a form of congenital heart disease each year, of which 25% are estimated to be critical congenital heart disease. We report two cases with an early critical congenital heart disease detection and intervention through an innovative critical congenital heart disease screening program implemented in two Mexican hospitals. They integrated a new automated pulse oximetry data analysis method and a comprehensive follow-up system (Cárdi-k®). Both cases were confirmed by echocardiogram, which served for an intervention in the first week of life, and the patients were discharged in good clinical condition. In addition, to the routine physical assessments, the critical congenital heart disease screening program (which includes echocardiogram for presumptive positive cases) should be implemented in a timely manner.

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Universal Pulse Oximetry Screening for Early Detection of Critical Congenital Heart Disease

Clinical Medicine Insights Pediatrics ◽

10.4137/cmped.s33086 ◽

2016 ◽

Vol 10 ◽

pp. CMPed.S33086 ◽

Cited By ~ 5

Author(s):

Praveen Kumar

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Early Detection ◽

Early Diagnosis ◽

Pulse Oximetry ◽

Congenital Heart ◽

Developed Countries ◽

The United States ◽

Critical Congenital Heart Disease ◽

Pulse Oximetry Screening

Critical congenital heart disease (CCHD) is a major cause of infant death and morbidity worldwide. An early diagnosis and timely intervention can significantly reduce the likelihood of an adverse outcome. However, studies from the United States and other developed countries have shown that as many as 30%–50% of infants with CCHD are discharged after birth without being identified. This diagnostic gap is likely to be even higher in low-resource countries. Several large randomized trials have shown that the use of universal pulse-oximetry screening (POS) at the time of discharge from birth hospital can help in early diagnosis of these infants. The objective of this review is to share data to show that the use of POS for early detection of CCHD meets the criteria necessary for inclusion to the universal newborn screening panel and could be adopted worldwide.

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