Cost-effectiveness of three-stage newborns hearing screening in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the cost-effectiveness of two-stage and three-stage hearing screenings for newborns.</p><p><b>METHODS</b>Hearing screening was performed for the normal newborns born in 7 hospitals in Beijing from October 2010 to December 2012 by using two stage and three stage strategies as well as hearing diagnostic test, and the cost effectiveness evaluation of two strategies was conducted. The data about the cost of screening and diagnostic test were from the hospitals. The data about car fare and charge for loss of working time of parents were collected through questionnaire survey. The sensitivity was analyzed according to the compliance rate.</p><p><b>RESULTS</b>A total of 62,695 newborns received initial hearing screening, 5,809 newborns failed, the positive rate was 9.30%. A total of 4,933 newborns received rescreening, 972 newborns failed, the positive rate was 19.70%. Among the newborns failed in rescreening, 412 were provided with hearing diagnostic test and 360 received diagnostic test. The diagnostic test indicated that the hearing of 217 newborns were abnormal (60.28%). A total of 276 newborns received the third screening, 163 newborns failed, in which 125 received diagnostic test and 112 had abnormal hearing (45 had moderate and above hearing impairment), the abnormal rate was 89.60%. The average cost for three-stage screening (37,242 yuan RMB per case) was higher than that for two-stage screening (19,985 yuan RMB per case). With the increase of compliance, the cost-effectiveness of three-stage screening increased.</p><p><b>CONCLUSION</b>The cost-effectiveness of three-stage screening was influenced by screening compliance. It is recommended that three-stage screening strategy might be taken in area where the screening compliance rate is >90%.</p>

Preliminary application of multi-slice CT direct venography in lower extremity vein / 中国医学影像技术

Objective To discuss the injective method, contrast agent concentration and delay time of MSCT direct venography in lower extremity vein, in order to make optimal venographic schedule. Methods Thirty-two patients with lower extremity vein diseases underwent MSCT direct venography in using different concentration and injective rate of contrast agent, and the images were analyzed. The displaying ability of MSCT direct venography in lower extremity vein segment was compared with that of X-ray venography in 22 patients. Results Blood flow correlation constructed defect was the main factor impacting image quality of CT venography in lower extremity. The image scores between the groups of injective rate 1.5 ml/s and the group of 2.5 ml/s were statistically different (χ~2=5.495, P=0.019), whereas no difference of image score was found between the group of concentration of 25% and 15% (χ~2=3.333, P=0.068). The displaying ability of CT and X-ray venography in anterior tibial vein, posterior tibial vein, popliteal vein and femoral vein was not statistically different (χ~2=2.095, P=0.148). For iliac vein, the displaying ability of CT outstripped that of X-ray venography (χ~2=8.324, P=0.004). Conclusion With the schedule of delay time 50 s, injective rate 2.5 ml/s and concentration 45 mgI/ml (nonionic 300 mgI/ml and diluted 15%), MSCT direct venography in lower extremity can acquire satisfactory image, and its displaying ability of iliac vein is better than that of X-ray venography.