Analytical approach:
Two decision tree models were used to combine published evidence to inform on the likely consequences of the alternative screening strategies on a hypothetical cohort of 100,000 newborn infants. The base case analysis took the perspective of the healthcare system. A secondary analysis took a societal perspective.
Effectiveness data:
Effectiveness data were derived from published studies. The main clinical effectiveness estimates were sensitivity and specificity of TEOAE and AABR. These estimates were derived from a previously published cost-effectiveness analysis.
Monetary benefit and utility valuations:
Not relevant.
Measure of benefit:
The primary measure of benefit was the number of detected true positive cases of hearing impairment.
Cost data:
The base-case analysis (healthcare system perspective) included direct costs associated with the TEOAE and AABR screening methods, resource use estimates associated with screening and a cost of false positive results. Costs of screening methods included costs of screening interventions and medical supplies. Resource costs included costs of a co-ordinator, screener, clerk and audiologist. Cost of a false positive result was assumed to be an additional cost of an outpatient audiologist visit. Cost estimates were obtained from studies in the published literature.
The secondary analysis (societal perspective) included travel time and lost productivity and an estimate of the lifetime societal costs in USA from a single published study.
Costs were provided in 2010 UK pounds sterling (£) in the base-case analysis; costs were converted into Indian Rupees (INR) where relevant.
Analysis of uncertainty:
Deterministic sensitivity analysis was performed to assess the impact of uncertainty around key parameters on results.