EUSCREEN: A Pan-European Study of Child Vision and Hearing Screening Programmes
Published in 2021, the EUSCREEN study was a large, pan-European academic study of child vision and hearing screening programmes. No surprise that it’s of huge interest to us at Thomson Screening.
Here we take an overview, to consider its aims, methodology and top-line results. We’ll look in more depth at specifics, later.
Objectives of EUSCREEN
The EUSCREEN study ran from 2017-21. It aimed to compare vision and hearing screening programmes for children across the EU. They used an online cost-effectiveness model to predict the most affordable way to screen children in each country, given local circumstances.
In addition to this model, the EUSCREEN project also developed a manual for the implementation or modification of child vision and hearing screening programmes.
The primary objective of the two initiatives is to assist healthcare providers and policy makers anywhere in the world. It’s freely available when they wish to modify existing screening programmes or introduce new initiatives. Typically, they’ll use it when they wish to increase effectiveness, coverage and efficiency.
Methods and Findings of EUSCREEN
EUSCREEN first took a snapshot of current screening across Europe. This was to identify shortcomings and develop tools for improvement. A detailed survey of 46 countries was conducted to gather data on:
- the prevalence of a lazy eye and hearing impairment,
- screening age,
- screening tests, coverage and attendance.
- screening professionals,
- referral rates,
- lack of follow-up,
- screening costs and more.
They found that 13 different types of professional screen children. To measure visual acuity between ages 3 and 7, 35 different charts with pictures or numbers were used.
Regarding hearing, the survey found that universal new-born screening was carried out in 26 high-income countries and three low/middle-income ones.
It also revealed that the frequency of screening and the choice of screening method are strongly related to health expenditure and the human development index.
An Opportunity Missed?
One challenge that the study commented on but offered little to resolve was that of data. Across Europe, there was a clear lack of monitoring, data collection, quality control and evaluation, even in the most developed screening programmes.
There are ways to gather data, anonymised of course. SchoolScreener®, for example, has been able to do this for many years. The EUSCREEN study didn’t approach us to use our data though. Currently, we do share it with bona fide researchers, such as the group at City, University of London who are expected to publish their results later in 2022.
While EUSCREEN did consider the relative cost effectiveness of using photo-screeners vs. orthoptist-delivered screening, they seem to have omitted other methods. Most notably the orthoptist-led but nurse-delivered (or screener-delivered) methods favoured by most school nursing providers in the UK. These are known to be most efficient when they used specifically developed software for administrative, reporting and communications functions.
Implementation Manual and Cost Effectiveness Model
The resources output of this €4.3m study included the cost-effectiveness model, the implementation manual and publication of country-by-country reports on the EUSCREEN website. There’s also a comprehensive list of contributory and reference articles.
A short synopsis has been posted on CORDIS; the website devoted to EU-funded research results.
We’ve found a lot of interest in the EUSCREEN study and propose to summarise and comment upon different aspects of it over the coming weeks.