Effectiveness of pulse oximetry screening for congenital heart disease in asymptomatic new-borns

Lanker, Audil Mohmad; Chowdhary, Javed; Jeelani, Nasir; Jeelani, Shazia; Hassan, Ashfaq Ul; Wani, Nasir-ud-din

doi:10.5455/2320-6012.ijrms20140894

Cited by 6 publications

(11 citation statements)

References 26 publications

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“…Congenital heart disease (CHD) is the most common congenital malformation [1][2][3][4][5][6] accounting for 28% of major anomalies 1 and 6-10% of infant deaths 3,7,8 . Prevalence has increased substantially over time to 1.35million newborns annually 1,10 with 5-10 per 1000 live births 1,2,[8][9][10][11][14][15][16][17] with the highest prevalence in Asia and categorized into four basic categories: critical, serious, significant and non significant 4,7,14 .…”

Section: Introductionmentioning

confidence: 99%

“…Critical congenital heart disease (CCHD) is defined as "any potentially life threatening duct dependant disorder within first 28 days of life" 4,7,[13][14][15][16]18 and the incidence is 1.2-1.7:1000 live births 3,6,8,19,20 accounting for 10-15% cases of CHD 8 . Current increasing tendency of early discharge of asymptomatic newborns 2,3,15,[21][22][23][24] before 24 hours 7,18 has raised concern 15,21,22,24 , since the effects of duct closure may not be apparent 3,11,13,21,25 , thereby making many babies with CCHD leaving hospital undiagnosed 4,5,7,17,21 , allowing 1/3 of babies to be symptomatic at home 2,3,18,21,24 and 1 in 4 (25%) to die 15,16,24 .…”

Section: Introductionmentioning

confidence: 99%

“…Missed or delayed diagnosis of CCHD is associated with significant morbidity 2,[5][6][7][8][9]11,19 and 12 times 15,16 higher mortality during infancy [2][3][4][5][6][7][8][9][10][11]15,[17][18][19][20]26 and over 80% deaths in early neonatal period 24 . Timely diagnosis of CCHD, by 2D echocardiography, provides opportunity for timely intervention [5][6][7][8]11,22,23 in order to improve survival 5,7,11,15,23 and to reduce morbidity 4,5,7,9,[11][12][13][14][15][16][17][18]…”

Section: Introductionmentioning

confidence: 99%

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Comparison of pulse oximetry screening versus routine clinical examination in detecting critical congenital heart disease in newborns

Gunaratne

Hewage

Fonseka³

et al. 2021

Sri Lanka J Child Health

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Introduction: Critical congenital heart disease (CCHD) in newborns has a worldwide prevalence of 1-2 per 1000 live births and often remain asymptomatic pre-discharge, leading to significant morbidity and mortality. Screening depends on physical examination (PE) and pulse oximetry (PO) which is proposed as a novel method. Objective: Evaluate efficacy and suitability of PO as a screening strategy of CCHD compared to PE in the Sri Lankan setup. Method: A prospective study was conducted in 5435 asymptomatic newborns, period of amenorrhoea (POA) ≥34weeks, aged ≥24 hours, in Castle Street Hospital for Women, Colombo. Preductal and post-ductal oxygen saturation (SpO2) measurements in right hand (RH) and right foot (RF) along with PE were performed. Babies without SpO2 thresholds of ≥95% in RH and RF and ≤3% difference between RH and RF or with abnormal PE, underwent 2D echocardiogram. Results: Detection rate of CCHD by PO and PE were 91% and 82% respectively. Addition of PO screening to PE detected 02 missed cases. PO and PE sensitivities were 90.9% and 81.8% (p=0.54) and 100% in combination (p=0.8), and specificities were 99.9% and 98.2% respectively (p=0.37) and 98.1% in combination. Positive predictive value _________________________________________

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of pulse oximetry screening versus routine clinical examination in detecting critical congenital heart disease in newborns

Gunaratne

Hewage

Fonseka³

et al. 2021

Sri Lanka J Child Health

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“…After birth, CCHDs may be identified by physical examination within the first 24 h and through other diagnostic tests like EKG or chest X-ray; however, these tests lack the necessary sensitivity to detect most cases [6]. For this reason, it is necessary to consider other early detection techniques such as pulse oximetry, which is a highly sensitive, well-established, non-invasive test for the objective quantification of hypoxemia, which may be suitable for the routine screening of CCHD [7, 8]. Use of this screening method for early detection of congenital heart defects is based on the rationale that clinically undetectable hypoxemia is present, to some degree, in most potentially life-threatening cases.…”

Section: Introductionmentioning

confidence: 99%

“…Use of this screening method for early detection of congenital heart defects is based on the rationale that clinically undetectable hypoxemia is present, to some degree, in most potentially life-threatening cases. Pulse oximetry has been previously assessed as a screening method for congenital heart defects in newborns [8]. The primary benefit of newborn screening for CCHD with pulse oximetry is timely identification before hospital discharge, thereby minimizing the morbidity and mortality associated with delayed diagnosis [9–11].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of newborn pulse oximetry screening to detect critical congenital heart disease in Colombia

Trujillo

Reyes

Restrepo

et al. 2019

Cost Eff Resour Alloc

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Background In many countries, economic assessments of the routine use of pulse oximetry in the detection of Critical Congenital Heart Disease (CCHD) at birth has not yet been carried out. CCHDs necessarily require medical intervention within the first months of life. This assessment is a priority in low and medium resource countries. The purpose of this study was to assess the cost-effectiveness (CE) relation of pulse oximetry in the detection of cases of CCHD in Colombia. Methods A full economic assessment of the cost-effectiveness type was conducted from the perspective of society. A decision tree was constructed to establish a comparison between newborn physical examination plus pulse oximetry, versus physical examination alone, in the diagnosis of CCHDs. The sensitivity and specificity of pulse oximetry were estimated from a systematic review of the literature; to assess resource use, micro-costing analyses and surveys were conducted. The time horizon of the economic evaluation was the first week after birth and until the first year of life. The incremental cost-effectiveness ratio (ICER) was determined and, to control for uncertainty, deterministic and probabilistic sensitivity analysis were made, including the adoption of different scenarios of budgetary impact. All costs are expressed in US dollars from 2017, using the average exchange rate for 2017 [$2,951.15 COP for 1 dollar]. Results The costs of pulse oximetry screening plus physical examination were $102; $7 higher than physical examination alone. The effectiveness of pulse oximetry plus the physical examination was 0.93; that is, 0.07 more than the physical examination on its own. The ICER was $100 for pulse oximetry screening; that is, if one wishes to increase 1% the probability of a correct CCHD diagnosis, this amount would have to be invested. A willingness to pay of $26.292 USD (direct medical cost) per probability of a correct CCHD diagnosis was assumed. Conclusions At current rates and from the perspective of society, newborn pulse oximetry screening at 24 h in addition to physical examination, and considering a time horizon of 1 week, is a cost-effective strategy in the early diagnosis of CCHDs in Colombia. Trial registration “retrospectively registered”.

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An Update on Critical Congenital Heart Disease Screening Using Pulse Oximetry

2016

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Effectiveness of pulse oximetry screening for congenital heart disease in asymptomatic new-borns

Cited by 6 publications

References 26 publications

Comparison of pulse oximetry screening versus routine clinical examination in detecting critical congenital heart disease in newborns

Comparison of pulse oximetry screening versus routine clinical examination in detecting critical congenital heart disease in newborns

Cost-effectiveness analysis of newborn pulse oximetry screening to detect critical congenital heart disease in Colombia

An Update on Critical Congenital Heart Disease Screening Using Pulse Oximetry

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