Evidence map›Paper›PMID 31796510›Full record

ArticleCMAJ open

Iron deficiency screening for children at 18 months: a cost-utility analysis.

Sarah Carsley, Rui Fu, Cornelia M Borkhoff, Nadine Reid, Eva Baginska, Catherine S Birken, Jonathon L Maguire, Rebecca Hancock-Howard, Patricia C Parkin, Peter C Coyte

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PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sarah CarsleyHealth Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Institute of Health Policy, Management and Evaluation (Fu, Borkhoff, Reid, Baginska, Birken, Maguire, Hancock-Howard, Parkin, Coyte), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences (Borkhoff, Birken, Parkin), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children; Division of Pediatric Medicine and the Pediatric Outcomes Research Team (Borkhoff, Birken, Maguire, Parkin), Department of Pediatrics, Faculty of Medicine, University of Toronto, The Hospital for Sick Children; Department of Pediatrics (Maguire), St. Michael's Hospital and Li Ka Shing Knowledge Institute; Department of Nutritional Sciences (Birken, Maguire), University of Toronto, Toronto, Ont. sarah.carsley@oahpp.ca.
Rui FuHealth Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Institute of Health Policy, Management and Evaluation (Fu, Borkhoff, Reid, Baginska, Birken, Maguire, Hancock-Howard, Parkin, Coyte), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences (Borkhoff, Birken, Parkin), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children; Division of Pediatric Medicine and the Pediatric Outcomes Research Team (Borkhoff, Birken, Maguire, Parkin), Department of Pediatrics, Faculty of Medicine, University of Toronto, The Hospital for Sick Children; Department of Pediatrics (Maguire), St. Michael's Hospital and Li Ka Shing Knowledge Institute; Department of Nutritional Sciences (Birken, Maguire), University of Toronto, Toronto, Ont.
Cornelia M BorkhoffHealth Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Institute of Health Policy, Management and Evaluation (Fu, Borkhoff, Reid, Baginska, Birken, Maguire, Hancock-Howard, Parkin, Coyte), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences (Borkhoff, Birken, Parkin), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children; Division of Pediatric Medicine and the Pediatric Outcomes Research Team (Borkhoff, Birken, Maguire, Parkin), Department of Pediatrics, Faculty of Medicine, University of Toronto, The Hospital for Sick Children; Department of Pediatrics (Maguire), St. Michael's Hospital and Li Ka Shing Knowledge Institute; Department of Nutritional Sciences (Birken, Maguire), University of Toronto, Toronto, Ont.
Nadine ReidHealth Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Institute of Health Policy, Management and Evaluation (Fu, Borkhoff, Reid, Baginska, Birken, Maguire, Hancock-Howard, Parkin, Coyte), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences (Borkhoff, Birken, Parkin), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children; Division of Pediatric Medicine and the Pediatric Outcomes Research Team (Borkhoff, Birken, Maguire, Parkin), Department of Pediatrics, Faculty of Medicine, University of Toronto, The Hospital for Sick Children; Department of Pediatrics (Maguire), St. Michael's Hospital and Li Ka Shing Knowledge Institute; Department of Nutritional Sciences (Birken, Maguire), University of Toronto, Toronto, Ont.
Eva BaginskaHealth Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Institute of Health Policy, Management and Evaluation (Fu, Borkhoff, Reid, Baginska, Birken, Maguire, Hancock-Howard, Parkin, Coyte), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences (Borkhoff, Birken, Parkin), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children; Division of Pediatric Medicine and the Pediatric Outcomes Research Team (Borkhoff, Birken, Maguire, Parkin), Department of Pediatrics, Faculty of Medicine, University of Toronto, The Hospital for Sick Children; Department of Pediatrics (Maguire), St. Michael's Hospital and Li Ka Shing Knowledge Institute; Department of Nutritional Sciences (Birken, Maguire), University of Toronto, Toronto, Ont.
Catherine S BirkenHealth Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Institute of Health Policy, Management and Evaluation (Fu, Borkhoff, Reid, Baginska, Birken, Maguire, Hancock-Howard, Parkin, Coyte), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences (Borkhoff, Birken, Parkin), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children; Division of Pediatric Medicine and the Pediatric Outcomes Research Team (Borkhoff, Birken, Maguire, Parkin), Department of Pediatrics, Faculty of Medicine, University of Toronto, The Hospital for Sick Children; Department of Pediatrics (Maguire), St. Michael's Hospital and Li Ka Shing Knowledge Institute; Department of Nutritional Sciences (Birken, Maguire), University of Toronto, Toronto, Ont.
Jonathon L MaguireHealth Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Institute of Health Policy, Management and Evaluation (Fu, Borkhoff, Reid, Baginska, Birken, Maguire, Hancock-Howard, Parkin, Coyte), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences (Borkhoff, Birken, Parkin), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children; Division of Pediatric Medicine and the Pediatric Outcomes Research Team (Borkhoff, Birken, Maguire, Parkin), Department of Pediatrics, Faculty of Medicine, University of Toronto, The Hospital for Sick Children; Department of Pediatrics (Maguire), St. Michael's Hospital and Li Ka Shing Knowledge Institute; Department of Nutritional Sciences (Birken, Maguire), University of Toronto, Toronto, Ont.
Rebecca Hancock-HowardHealth Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Institute of Health Policy, Management and Evaluation (Fu, Borkhoff, Reid, Baginska, Birken, Maguire, Hancock-Howard, Parkin, Coyte), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences (Borkhoff, Birken, Parkin), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children; Division of Pediatric Medicine and the Pediatric Outcomes Research Team (Borkhoff, Birken, Maguire, Parkin), Department of Pediatrics, Faculty of Medicine, University of Toronto, The Hospital for Sick Children; Department of Pediatrics (Maguire), St. Michael's Hospital and Li Ka Shing Knowledge Institute; Department of Nutritional Sciences (Birken, Maguire), University of Toronto, Toronto, Ont.
Patricia C ParkinHealth Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Institute of Health Policy, Management and Evaluation (Fu, Borkhoff, Reid, Baginska, Birken, Maguire, Hancock-Howard, Parkin, Coyte), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences (Borkhoff, Birken, Parkin), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children; Division of Pediatric Medicine and the Pediatric Outcomes Research Team (Borkhoff, Birken, Maguire, Parkin), Department of Pediatrics, Faculty of Medicine, University of Toronto, The Hospital for Sick Children; Department of Pediatrics (Maguire), St. Michael's Hospital and Li Ka Shing Knowledge Institute; Department of Nutritional Sciences (Birken, Maguire), University of Toronto, Toronto, Ont.
Peter C CoyteHealth Promotion, Chronic Disease and Injury Prevention (Carsley), Public Health Ontario; Institute of Health Policy, Management and Evaluation (Fu, Borkhoff, Reid, Baginska, Birken, Maguire, Hancock-Howard, Parkin, Coyte), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences (Borkhoff, Birken, Parkin), Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children; Division of Pediatric Medicine and the Pediatric Outcomes Research Team (Borkhoff, Birken, Maguire, Parkin), Department of Pediatrics, Faculty of Medicine, University of Toronto, The Hospital for Sick Children; Department of Pediatrics (Maguire), St. Michael's Hospital and Li Ka Shing Knowledge Institute; Department of Nutritional Sciences (Birken, Maguire), University of Toronto, Toronto, Ont.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe peak prevalence of iron deficiency is in children 6 months to 3 years of age, a sensitive period for neurodevelopment. Our study objective was to examine the cost-utility of a proposed iron deficiency screening program for 18-month-old children.

methodsWe used a decision tree model to estimate the costs in 2019 Canadian dollars and quality-adjusted life years (QALYs) associated with 3 iron deficiency screening strategies: no screening, universal screening and targeted screening for a high-risk population. We used a societal perspective and assessed lifetime QALY gains. We derived outcomes from the literature and prospectively collected data. We performed one-way and probabilistic sensitivity analyses to assess parameter uncertainty.

resultsThe incremental costs to society of universal and targeted screening programs compared to no screening were $2286.06/QALY and $1676.94/QALY, respectively. With a willingness-to-pay threshold of $50 000/QALY, both programs were cost-effective. Compared to a targeted screening program, a universal screening program would cost an additional $2965.96 to gain 1 QALY, which renders it a cost-effective option. The study findings were robust to extensive sensitivity analyses.

interpretationA proposed universal screening program for iron deficiency would be cost-effective over the lifespan compared to both no screening (current standard of care) and a targeted screening program for children at high risk. Policy-makers and physicians may consider expanding the recommended 18-month enhanced well-baby visit to include screening for iron deficiency.

Identifiers

PMID31796510
PMCPMC6890493

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.