The cost-effectiveness of screening tools used in the diagnosis of fetal alcohol spectrum disorder: a modelled analysis Article Swipe
Patrick Berrigan
,
Gail Andrew
,
James N. Reynolds
,
Jennifer Zwicker
·
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.1186/s12889-019-8110-5
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.1186/s12889-019-8110-5
Background Fetal Alcohol Spectrum Disorder (FASD) is characterized by physical and neurological abnormalities resulting from prenatal alcohol exposure. Though diagnosis may help improve patient outcomes, the diagnostic process can be costly. Subsequently, screening children suspected of FASD prior to diagnostic testing has been suggested, to avoid administering testing to children who are unlikely to receive a diagnosis. The present study set out to assess the cost-effectiveness of currently recommended FASD screening tools. Methods The screenings tools evaluated were chosen from Children’s Healthcare Canada’s National Screening Toolkit for Children and Youth Identified and Potentially Affected by FASD and include meconium testing of fatty acid ethyl esters (meconium testing) and the neurobehavioral screening tool (NST). An economic model was constructed to assess cost-effectiveness. One-way and probabilistic sensitivity analyses were conducted to assess the robustness of findings. Costs reflect 2017 Canadian dollars and the perspective is the public healthcare system. Results Both screening tools evaluated resulted in reduced costs and fewer diagnosed years of life than a no screening strategy in which all children suspected of FASD receive diagnostic testing. The model predicts that screening newborns with meconium testing results in a reduced cost of $89,186 per 100 individuals screened and 38 fewer diagnosed years of life by age 18, corresponding to an incremental cost-effectiveness ratio (ICER) of $2359. Screening children with the NST resulted in a reduced cost of $183,895 per 100 individuals screened and 77 fewer diagnosed years of life by age 18, corresponding to an ICER of $2390. Conclusion Findings suggest that screening is associated with less use of healthcare recourses but also fewer years of life with an FASD diagnosis over a no screening strategy. Since diagnosis can be key to children receiving timely and appropriate health and educational services, cost-savings must be weighed against the fewer years of life with a diagnosis associated with screening.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1186/s12889-019-8110-5
- https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-019-8110-5
- OA Status
- gold
- Cited By
- 10
- References
- 34
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2997752540
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W2997752540Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1186/s12889-019-8110-5Digital Object Identifier
- Title
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The cost-effectiveness of screening tools used in the diagnosis of fetal alcohol spectrum disorder: a modelled analysisWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2019Year of publication
- Publication date
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2019-12-01Full publication date if available
- Authors
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Patrick Berrigan, Gail Andrew, James N. Reynolds, Jennifer ZwickerList of authors in order
- Landing page
-
https://doi.org/10.1186/s12889-019-8110-5Publisher landing page
- PDF URL
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https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-019-8110-5Direct link to full text PDF
- Open access
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-019-8110-5Direct OA link when available
- Concepts
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Biostatistics, Medicine, Fetal Alcohol Spectrum Disorder, Public health, Epidemiology, Fetal alcohol syndrome, Alcohol, Psychiatry, Medical emergency, Pregnancy, Pathology, Biology, Chemistry, Genetics, BiochemistryTop concepts (fields/topics) attached by OpenAlex
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10Total citation count in OpenAlex
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2025: 1, 2024: 1, 2023: 1, 2022: 2, 2021: 5Per-year citation counts (last 5 years)
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34Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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