Effectiveness and cost-effectiveness of height-screening programmes during the primary school years: A systematic review

D. Fayter, J. Nixon, S. Hartley, A. Rithalia, G. Butler, M. Rudolf, P. Glasziou, M. Bland, L. Stirk, M. Westwood

Research output: Contribution to journalReview articleResearchpeer-review

23 Citations (Scopus)

Abstract

Objective: To determine the effectiveness and cost-effectiveness of height screening (of children aged 4 to 11) to identify height-related conditions.

Design: Systematic review and economic modelling.

Setting and intervention: We included published and unpublished screening studies of any design, except case reports, conducted in any setting that measured children's height as part of a population-level assessment. Studies were identified by electronic database searches, contact with experts and from bibliographies of retrieved studies.

Participants: Children aged between 4 and 11 years.

Outcome measures: Diagnostic yield of height-related conditions and change in quality of life, as measured by quality-adjusted life years (QALYs), for early versus late treatment of underlying conditions.

Results: Twelve studies described a height-screening programme and provided data on the diagnostic yield of newly diagnosed height-related conditions. Where reported, yield for growth-hormone deficiency (per 1000 children screened) ranged from 0.05 (1 in 20 000) to 0.62 (approximately 1 in 1500) and for Turner syndrome (per 1000 children screened) was between 0.02 (1 in 50 000) and 0.07 (approximately 1 in 14 000). As a secondary gain, children with other potentially treatable conditions were identified; diagnostic yields ranged from 0.22 to 1.84 per 1000 children screened. Three studies did not detect any new cases, but all of these studies had methodological limitations. Economic modelling suggested that height screening is associated with health improvements and is cost effective for a willingness to pay threshold of 30 pound 000 per QALY.

Conclusions: This review indicates the utility and acceptable cost-effectiveness of height screening arising from increased detection of height-related disorders and secondary pick-up of other undiagnosed conditions. Further research is needed to obtain more reliable data on quality of life gains and costs associated with early interventions for height-related conditions. The exact role of height-screening programmes in improving child health remains to be determined.

Original languageEnglish
Pages (from-to)278-284
Number of pages7
JournalArchives of Disease in Childhood
Volume93
Issue number4
DOIs
Publication statusPublished - Apr 2008
Externally publishedYes

Cite this

Fayter, D. ; Nixon, J. ; Hartley, S. ; Rithalia, A. ; Butler, G. ; Rudolf, M. ; Glasziou, P. ; Bland, M. ; Stirk, L. ; Westwood, M. / Effectiveness and cost-effectiveness of height-screening programmes during the primary school years : A systematic review. In: Archives of Disease in Childhood. 2008 ; Vol. 93, No. 4. pp. 278-284.
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abstract = "Objective: To determine the effectiveness and cost-effectiveness of height screening (of children aged 4 to 11) to identify height-related conditions.Design: Systematic review and economic modelling.Setting and intervention: We included published and unpublished screening studies of any design, except case reports, conducted in any setting that measured children's height as part of a population-level assessment. Studies were identified by electronic database searches, contact with experts and from bibliographies of retrieved studies.Participants: Children aged between 4 and 11 years.Outcome measures: Diagnostic yield of height-related conditions and change in quality of life, as measured by quality-adjusted life years (QALYs), for early versus late treatment of underlying conditions.Results: Twelve studies described a height-screening programme and provided data on the diagnostic yield of newly diagnosed height-related conditions. Where reported, yield for growth-hormone deficiency (per 1000 children screened) ranged from 0.05 (1 in 20 000) to 0.62 (approximately 1 in 1500) and for Turner syndrome (per 1000 children screened) was between 0.02 (1 in 50 000) and 0.07 (approximately 1 in 14 000). As a secondary gain, children with other potentially treatable conditions were identified; diagnostic yields ranged from 0.22 to 1.84 per 1000 children screened. Three studies did not detect any new cases, but all of these studies had methodological limitations. Economic modelling suggested that height screening is associated with health improvements and is cost effective for a willingness to pay threshold of 30 pound 000 per QALY.Conclusions: This review indicates the utility and acceptable cost-effectiveness of height screening arising from increased detection of height-related disorders and secondary pick-up of other undiagnosed conditions. Further research is needed to obtain more reliable data on quality of life gains and costs associated with early interventions for height-related conditions. The exact role of height-screening programmes in improving child health remains to be determined.",
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Fayter, D, Nixon, J, Hartley, S, Rithalia, A, Butler, G, Rudolf, M, Glasziou, P, Bland, M, Stirk, L & Westwood, M 2008, 'Effectiveness and cost-effectiveness of height-screening programmes during the primary school years: A systematic review' Archives of Disease in Childhood, vol. 93, no. 4, pp. 278-284. https://doi.org/10.1136/adc.2006.109843

Effectiveness and cost-effectiveness of height-screening programmes during the primary school years : A systematic review. / Fayter, D.; Nixon, J.; Hartley, S.; Rithalia, A.; Butler, G.; Rudolf, M.; Glasziou, P.; Bland, M.; Stirk, L.; Westwood, M.

In: Archives of Disease in Childhood, Vol. 93, No. 4, 04.2008, p. 278-284.

Research output: Contribution to journalReview articleResearchpeer-review

TY - JOUR

T1 - Effectiveness and cost-effectiveness of height-screening programmes during the primary school years

T2 - A systematic review

AU - Fayter, D.

AU - Nixon, J.

AU - Hartley, S.

AU - Rithalia, A.

AU - Butler, G.

AU - Rudolf, M.

AU - Glasziou, P.

AU - Bland, M.

AU - Stirk, L.

AU - Westwood, M.

PY - 2008/4

Y1 - 2008/4

N2 - Objective: To determine the effectiveness and cost-effectiveness of height screening (of children aged 4 to 11) to identify height-related conditions.Design: Systematic review and economic modelling.Setting and intervention: We included published and unpublished screening studies of any design, except case reports, conducted in any setting that measured children's height as part of a population-level assessment. Studies were identified by electronic database searches, contact with experts and from bibliographies of retrieved studies.Participants: Children aged between 4 and 11 years.Outcome measures: Diagnostic yield of height-related conditions and change in quality of life, as measured by quality-adjusted life years (QALYs), for early versus late treatment of underlying conditions.Results: Twelve studies described a height-screening programme and provided data on the diagnostic yield of newly diagnosed height-related conditions. Where reported, yield for growth-hormone deficiency (per 1000 children screened) ranged from 0.05 (1 in 20 000) to 0.62 (approximately 1 in 1500) and for Turner syndrome (per 1000 children screened) was between 0.02 (1 in 50 000) and 0.07 (approximately 1 in 14 000). As a secondary gain, children with other potentially treatable conditions were identified; diagnostic yields ranged from 0.22 to 1.84 per 1000 children screened. Three studies did not detect any new cases, but all of these studies had methodological limitations. Economic modelling suggested that height screening is associated with health improvements and is cost effective for a willingness to pay threshold of 30 pound 000 per QALY.Conclusions: This review indicates the utility and acceptable cost-effectiveness of height screening arising from increased detection of height-related disorders and secondary pick-up of other undiagnosed conditions. Further research is needed to obtain more reliable data on quality of life gains and costs associated with early interventions for height-related conditions. The exact role of height-screening programmes in improving child health remains to be determined.

AB - Objective: To determine the effectiveness and cost-effectiveness of height screening (of children aged 4 to 11) to identify height-related conditions.Design: Systematic review and economic modelling.Setting and intervention: We included published and unpublished screening studies of any design, except case reports, conducted in any setting that measured children's height as part of a population-level assessment. Studies were identified by electronic database searches, contact with experts and from bibliographies of retrieved studies.Participants: Children aged between 4 and 11 years.Outcome measures: Diagnostic yield of height-related conditions and change in quality of life, as measured by quality-adjusted life years (QALYs), for early versus late treatment of underlying conditions.Results: Twelve studies described a height-screening programme and provided data on the diagnostic yield of newly diagnosed height-related conditions. Where reported, yield for growth-hormone deficiency (per 1000 children screened) ranged from 0.05 (1 in 20 000) to 0.62 (approximately 1 in 1500) and for Turner syndrome (per 1000 children screened) was between 0.02 (1 in 50 000) and 0.07 (approximately 1 in 14 000). As a secondary gain, children with other potentially treatable conditions were identified; diagnostic yields ranged from 0.22 to 1.84 per 1000 children screened. Three studies did not detect any new cases, but all of these studies had methodological limitations. Economic modelling suggested that height screening is associated with health improvements and is cost effective for a willingness to pay threshold of 30 pound 000 per QALY.Conclusions: This review indicates the utility and acceptable cost-effectiveness of height screening arising from increased detection of height-related disorders and secondary pick-up of other undiagnosed conditions. Further research is needed to obtain more reliable data on quality of life gains and costs associated with early interventions for height-related conditions. The exact role of height-screening programmes in improving child health remains to be determined.

U2 - 10.1136/adc.2006.109843

DO - 10.1136/adc.2006.109843

M3 - Review article

VL - 93

SP - 278

EP - 284

JO - Archives of Disease in Childhood

JF - Archives of Disease in Childhood

SN - 0003-9888

IS - 4

ER -