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Benefits and harms adopted by health economic assessments evaluating antenatal and newborn screening programmes in OECD countries : a systematic review of 336 articles and reports
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Png, May Ee, Yang, Miaoqing, Taylor-Phillips, Sian, Ratushnyak, Svetlana, Roberts, Nia, White, Ashley, Hinton, Lisa, Boardman, Felicity K., McNiven, Abigail, Fisher, Jane, Thilaganathan, Baskaran, Oddie, Sam, Slowther, Anne-Marie, Shilton Osborne, Jenny, Petrou, Stavros and Rivero-Arias, Oliver (2022) Benefits and harms adopted by health economic assessments evaluating antenatal and newborn screening programmes in OECD countries : a systematic review of 336 articles and reports. Social Science & Medicine, 314 . 115428. doi:10.1016/j.socscimed.2022.115428 ISSN 0277-9536.
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Official URL: https://doi.org/10.1016/j.socscimed.2022.115428
Abstract
Background
Health economic assessments are used to determine whether the resources needed to generate net benefit from a screening programme, driven by multiple complex benefits and harms, are justifiable. We systematically identified the benefits and harms incorporated within economic assessments evaluating antenatal and newborn screening programmes.
Methods
For this systematic review and thematic analysis, we searched the published and grey literature from January 2000 to January 2021. Studies that included an economic evaluation of an antenatal or newborn screening programme in an OECD country were eligible. We identified benefits and harms using an integrative descriptive analysis, and illustrated a thematic framework. (Systematic review registration PROSPERO, CRD42020165236).
Findings
The searches identified 52,244 articles and reports and 336 (242 antenatal and 95 newborn) were included. Eighty-six subthemes grouped into seven themes were identified: 1) diagnosis of screened for condition, 2) life years and health status adjustments, 3) treatment, 4) long-term costs, 5) overdiagnosis, 6) pregnancy loss, and 7) spillover effects on family members. Diagnosis of screened for condition (115 studies, 47.5%), life-years and health status adjustments (90 studies, 37.2%) and treatment (88 studies, 36.4%) accounted for most of the benefits and harms evaluating antenatal screening. The same themes accounted for most of the benefits and harms included in studies assessing newborn screening. Overdiagnosis and spillover effects tended to be ignored.
Interpretation
Our proposed framework can be used to guide the development of future health economic assessments evaluating antenatal and newborn screening programmes, to prevent exclusion of important potential benefits and harms.
Item Type: | Journal Article | |||||||||||||||
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Subjects: | R Medicine > RJ Pediatrics | |||||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Prenatal diagnosis -- Cost effectiveness, Medical screening -- Cost effectiveness, Newborn infants -- Economic aspects, Pediatrics -- Economic aspects | |||||||||||||||
Journal or Publication Title: | Social Science & Medicine | |||||||||||||||
Publisher: | Elsevier | |||||||||||||||
ISSN: | 0277-9536 | |||||||||||||||
Official Date: | December 2022 | |||||||||||||||
Dates: |
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Volume: | 314 | |||||||||||||||
Article Number: | 115428 | |||||||||||||||
DOI: | 10.1016/j.socscimed.2022.115428 | |||||||||||||||
Status: | Peer Reviewed | |||||||||||||||
Publication Status: | Published | |||||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||||||||
Date of first compliant deposit: | 11 October 2022 | |||||||||||||||
Date of first compliant Open Access: | 2 November 2022 | |||||||||||||||
Funder: | This project was funded by the National Institute for Health Research (UK): Health Technology Assessment Programme (NIHR127489). | |||||||||||||||
RIOXX Funder/Project Grant: |
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