Background
Methods
Decision-analytic model: scope and perspective
Decision-analytic model: structure
Decision-analytic model: variable estimation
Name | Description | Mean (95% CI) | Source |
---|---|---|---|
p_Ltfu1_t | Probability of loss to follow-up before the initial hearing screening test with tracking | 0.045 (0.043; 0.047) | Pilot project ‘newborn auditory screening’ [8] |
p_Ltfu1_nt | Probability of loss to follow-up before the initial hearing screening test without tracking | 0.053 (0.051; 0.055) | Pilot project ‘newborn auditory screening’ [8] |
p_Ltfu2_t | Probability of loss to follow-up before 2nd test with tracking | 0.07 (0.057; 0.084) | Data from the state-wide screening programme for 2010 |
p_Ltfu2_nt | Probability of loss to follow-up before 2nd test without tracking | 0.51 (0.497; 0.524) | Data from the state-wide screening programme for 2010 |
p_Ltfu3_t | Probability of loss to follow-up before 3rd test with tracking | 0.08 (0.048; 0.117) | Data from the state-wide screening programme for 2010 |
p_Ltfu3_nt | Probability of loss to follow-up before 3rd test without tracking | 0.29 (0.256; 0.325) | Data from the state-wide screening programme for 2010 |
p_Ltfu4_t | Probability of loss to follow-up before 4th test with tracking | 0.07 (0.027; 0.133) | Data from the state-wide screening programme for 2010 |
p_Ltfu4_nt | Probability of loss to follow-up before 4th test without tracking | 0.18 (0.133; 0.239) | Data from the state-wide screening programme for 2010 |
p_fail_1st_test | Probability of failing the initial hearing screening test bilaterally | 0.006 (0.005; 0.007) | Pilot project ‘newborn auditory screening’ [8] |
p_fail_2nd_test | Probability of failing the 2nd test bilaterally | 0.202 (0.167; 0.241) | Pilot project ‘newborn auditory screening’* |
p_fail_3rd_test | Probability of failing the 3rd test bilaterally | 0.627 (0.512; 0.739) | Pilot project ‘newborn auditory screening’* |
p_fail_4th_test | Probability of failing the 4th test bilaterally | 0.609 (0.400; 0.785) | Pilot project ‘newborn auditory screening’* |
p_diagnosis_after_2nd_test | Probability of diagnosis after 2nd test | 0.11 (0.073; 0.159) | Data from the state-wide screening programme for 2010 |
p_diagnosis_after_3rd_test | Probability of diagnosis after 3rd test | 0.36 (0.261; 0.460) | Data from the state-wide screening programme for 2010 |
Name | Description | Item | Points | Point value | Mean | Source |
---|---|---|---|---|---|---|
c_OAE_inpatient | Costs of OAE performed in hospital | 1409 | 400 | 8.589704 Cent | €34.36 | DKG-NT [22] |
c_AABR_inpatient | Costs of AABR performed in hospital | 1408 | 888 | 8.589704 Cent | €76.28 | DKG-NT [22] |
c_lumpsum_ENT | Lump sum for office-based ENT physicians | 09210 | 680 | 3.5048 Cent | €23.83 | EBM [23] |
c_OAE_outpatient_ENT | Costs of OAE performed by office-based ENT physicians | 09324 | 340 | 3.5048 Cent | €11.92 | EBM [23] |
c_AABR_outpatient_ENT | Costs of AABR performed by office-based ENT physicians | 01706 | 705 | 3.5048 Cent | €24.71 | EBM [23] |
c_lumpsum_PA | Lump sum for office-based pediatric audiologists | 20210 | 865 | 3.5048 Cent | €30.32 | EBM [23] |
c_AABR_outpatient_PA | Costs of AABR performed by office-based pediatric audiologists | 20327 | 1535 | 3.5048 Cent | €53.80 | EBM [23] |
c_MEM_reflex_outpatient_PA | Costs of impedance test of the middle ear performed by office-based pediatric audiologists | 20323 | 220 | 3.5048 Cent | €7.71 | EBM [23] |
Name | OAE (in %) | AABR (in %) | Both, OAE and AABR (in %) | Mean | Comment |
---|---|---|---|---|---|
c_1st_test_2stagesa
| 95.2e/0f
| 4.8e/7.66f
| 0e/0f
| €42.22 | (0.952*c_OAE_inpatient+0.048*c_AABR_inpatient)+0.0766*c_AABR_inpatient |
c_2nd_test_1stage_ENTb
| 74.7 | 14.9 | 10.4 | €38.99 | (0.104g+0.149)*c_AABR_outpatient_ENT+0.747*c_OAE_outpatient_ENT+c_lumpsum_ENT |
c_3rd_test_1stage_ENTc
| 40.3 | 38.8 | 20.9 | €43.39 | (0.209g+0.388)*c_AABR_outpatient_ENT+0,403*c_OAE_outpatient_ENT+c_lumpsum_ENT |
c_test_PAd
| 0 | 100 | 0 | €91.83 | c_lumpsum_PA+c_MEM_reflex_outpatient_PA+c_AABR_outpatient_PA |
Personnel expenses | |
---|---|
Nurse (0.75 position; tariff part: E8) | €33,876 |
Epidemiologist (0.5 position; tariff part: E14) | €31,759 |
Personnel expenses total
|
€65,635
|
Non-personnel expenses | |
Printing costs (flyer, data sheets) | €1,500 |
Stamped addressed envelopes for hospitals and doctors’ offices (50 per week) | €1,590 |
Telephone/fax (40 per working day) | €1,000 |
Room | €4,200 |
Two desktop PCs | €3,000 |
One telephone (nationwide connection) | €100 |
Letters (eight per working day) | €1,000 |
Non-personnel expenses total
|
€12,390
|
Total costs
|
€78,025
|
Decision-analytic model: uncertainty and consistency
Data analysis
Results
Decision-analytic model: base case analysis
Intervention | Costs | Effects (cases detected) | ACER: Cost per case detected | ICER: Incremental cost per additional case detected |
---|---|---|---|---|
Tracking | €40.63 | 0.00051 | €79,667 | - |
No tracking | €40.12 | 0.00021 | €191,048 | €1,697 |
Decision-analytic model: sensitivity analyses
p_Ltfu2_t
a
|
Costs (€) of no tracking
|
Costs (€) of tracking
|
Incremental costs (€)
|
Effects of no tracking
|
Effects of tracking
|
Incremental effects
|
ICER
(€/case detected)
|
---|---|---|---|---|---|---|---|
0.04 | 40.12 | 40.64 | 0.52 | 0.00021 | 0.00053 | 0.00032 | 1,628 |
0.07* | 40.12* | 40.63* | 0.51* | 0.00021* | 0.00051* | 0.00030* | 1,697* |
0.11 | 40.12 | 40.62 | 0.50 | 0.00021 | 0.00050 | 0.00029 | 1,775 |
p_Ltfu2_nt
b
|
Costs (€) of no tracking
|
Costs (€) of tracking
|
Incremental costs (€)
|
Effects of no tracking
|
Effects of tracking
|
Incremental effects
|
ICER
(€/case detected)
|
0.26 | 40.19 | 40.63 | 0.44 | 0.00032 | 0.00051 | 0.00019 | 2,297 |
0.51* | 40.12* | 40.63* | 0.51* | 0.00021* | 0.00051* | 0.00030* | 1,697* |
0.77 | 40.04 | 40.63 | 0.59 | 0.00010 | 0.00051 | 0.00041 | 1,419 |
p_Ltfu3_t
c
|
Costs (€) of no tracking
|
Costs (€) of tracking
|
Incremental costs (€)
|
Effects of no tracking
|
Effects of tracking
|
Incremental effects
|
ICER
(€/case detected)
|
0.04 | 40.12 | 40.64 | 0.52 | 0.00021 | 0.00053 | 0.00032 | 1,620 |
0.08* | 40.12* | 40.63* | 0.51* | 0.00021* | 0.00051* | 0.00030* | 1,697* |
0.12 | 40.12 | 40.63 | 0.51 | 0.00021 | 0.00050 | 0.00029 | 1,793 |
p_Ltfu3_nt
d
|
Costs (€) of no tracking
|
Costs (€) of tracking
|
Incremental costs (€)
|
Effects of no tracking
|
Effects of tracking
|
Incremental effects
|
ICER
(€/case detected)
|
0.15 | 40.12 | 40.63 | 0.51 | 0.00024 | 0.00051 | 0.00027 | 1,853 |
0.29* | 40.12* | 40.63* | 0.51* | 0.00021* | 0.00051* | 0.00030* | 1,697* |
0.44 | 40.11 | 40.63 | 0.52 | 0.00018 | 0.00051 | 0.00033 | 1,551 |
p_Ltfu4_t
e
|
Costs (€) of no tracking
|
Costs (€) of tracking
|
Incremental costs (€)
|
Effects of no tracking
|
Effects of tracking
|
Incremental effects
|
ICER
(€/case detected)
|
0.04 | 40.12 | 40.63 | 0.51 | 0.00021 | 0.00052 | 0.00031 | 1,663 |
0.07* | 40.12* | 40.63* | 0.51* | 0.00021* | 0.00051* | 0.00030* | 1,697* |
0.11 | 40.12 | 40.63 | 0.51 | 0.00021 | 0.00050 | 0.00029 | 1,740 |
p_Ltfu4_nt
f
|
Costs (€) of no tracking
|
Costs (€) of tracking
|
Incremental costs (€)
|
Effects of no tracking
|
Effects of tracking
|
Incremental effects
|
ICER
(€/case detected)
|
0.09 | 40.12 | 40.63 | 0.51 | 0.00022 | 0.00051 | 0.00029 | 1,737 |
0.18* | 40.12* | 40.63* | 0.51* | 0.00021* | 0.00051* | 0.00030* | 1,697* |
0.27 | 40.12 | 40.63 | 0.51 | 0.00020 | 0.00051 | 0.00031 | 1,657 |
c_tracking
g
|
Costs (€) of no tracking
|
Costs (€) of tracking
|
Incremental costs (€)
|
Effects of no tracking
|
Effects of tracking
|
Incremental effects
|
ICER
(€/case detected)
|
2.28 | 40.12 | 40.62 | 0.50 | 0.00021 | 0.00051 | 0.00030 | 1,654 |
4.55* | 40.12* | 40.63* | 0.51* | 0.00021* | 0.00051* | 0.00030* | 1,697* |
6.83 | 40.12 | 40.65 | 0.53 | 0.00021 | 0.00051 | 0.00030 | 1,740 |