Cost-effectiveness of screening a 5 year old child for hearing loss using Sound Scouts compared with no screening: a decision model analysis

Objectives: The need for a universal hearing screening program for children entering school in Australia has been noted in two separate federal government hearing inquiries in the last decade, yet no program has been developed to date. Sound Scouts is a new innovative hearing screening application (app) that tests for hearing loss in children using a tablet device, often performed by parents at home. It tests for sensorineural or permanent conductive hearing loss and central auditory processing disorder in children. This study estimates the cost-effectiveness of screening an average 5 year old child for hearing loss using Sound Scouts at home, compared with usual practice.

Methods: A decision analytic model was developed to estimate the incremental costs and quality adjusted life years of administering Sound Scouts over a 20 year time horizon. Testing accuracy was based on comparison of Sound Scouts results to clinical testing, while other parameters were based on published data and population statistics. Costs were estimated from the perspective of the Australian health care system. Univariate and probabilistic sensitivity analyses were undertaken.

Results: It was estimated that Sound Scouts would result in an average incremental cost of A$316 and an average incremental increase in quality adjusted life years (QALYs) of 0.07. This resulted in an ICER of around A$4,472 per QALY gained, which is likely to be considered ‘cost-effective’ The cost-effectiveness acceptability curve indicated that screening with Sound Scouts has a 95% probability of being cost-effective using a threshold of A$60,000 per QALY.

Conclusions: Using Sound Scouts to screen five year old children for hearing loss (at home) before entering school is a cost effective method. However, further analysis on the cost of implementing a universal screening program must be conducted before the cost effectiveness of a universal screening program can be determined.