Cost-effectiveness and implications of newborn screening for prolongation of QT interval for the prevention of sudden infant death syndrome.

摘要: Abstract Objective: To determine the cost-effectiveness of universal and high-risk neonatal electrocardiographic (ECG) screening for QT prolongation as a predictor sudden infant death syndrome (SIDS) risk in theoretical group neonates. Study design: Incremental analysis with decision analytic modeling. A hypothetical cohort healthy, term infants was modeled, comparing options no screening, neonate screening. The strategy is speculative, because currently accepted methodology known identifying at high SIDS. Given uncertain mechanisms association between prolonged corrected interval (QTc) SIDS, analyses were repeated under different assumptions. Sensitivity also performed on all input variables both costs effectiveness. Results: Under assumption that detects long responsive to conventional therapy, $3403 per life year gained, whereas cost $18,465 additional gained. However, if effectiveness SIDS therapy falls below 10%, deteriorates $28,376 saved $118,900 robust broad array sensitivity analyses. Conclusions: acceptability heavily dependent pathophysiologic mechanism efficacy monitoring antiarrhythmic treatment. nature this must be elucidated before routine warranted. (J Pediatr 2000;136:481-9)