According to some cardiologists, the answer is yes.
However, MedPage Today reports that, in a recent study presented at the American College of Cardiology meetings, the positive predictive value of such a strategy was low, and that, “To screen enough children to identify one with complex congenital heart disease or potentially life-threatening arrhythmia, the cost was $42,904.”
Pediatricians have challenged this finding, calling mass screening for children, where an increasing number are being diagnosed with ADHD, “overkill.”
I’m a little skeptical myself, since more EKG screening will also generate business for cardiologists, as abnormal findings will lead to more tests, such as echocardiograms and Holter monitors, in addition to cardiology consultations.
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- Vaccines: Rising costs are putting children at risk
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{ 3 comments }
Hi, I’m not sure I follow the logic. They argue that screening is not cost-effective because it would cost $43,000 to find a single case with congenital heart disease or potentially life-threatening arrhythmia. But, assuming that the decision is made purely on financial terms, the cost should not be presented in isolation. Instead, it is only relevant when compared to how much it will cost to miss that child with potentially life-threatening conditions.
Any thoughts?
1 Word: IHSS…bad enough by itself, but add potent stimulants and sprinkle some strenuous athletic activity on top, and can you say “Len Bias”??… You can have all the EMB you want, and you’ll be writing a check for $42,000 only with 2 or 3 more zeros…
Agree with your EKG skepticism. Is it more cost effective to screen our ADD patients in the same manner as an athlete who presents for a sports physical? A family questionaire that asks about sudden death in < 50 year old family members and symtoms such as shortnes of breath, vital signs including blood pressure & perfusion of all 4 extremities, weight, body habitus, fitness level, cardiac auscultation, and regular reevaluation are easily done in primary care offices. The differential of sudden death in children and adolescents is one most pediatricians can recite readily – tracking these causes still remain elusive (& dynamic). My point is that one EKG may identify a W-P-W, but some of these cardiac causes are acquired over time – repeated testing (yearly? biannually?) is not cost effective. Regular follow-ups for children on stimulant medications makes more sense.
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