Rochelle Baker

The Contextualized Health Research Synthesis Program of the NL Centre for Applied Health Research has just published a new study on  LINK TO THE REPORT and will present the findings from this report at a dissemination event on Thursday, December 13, 2018 | 2:00pm-3:00pm NLCAHR Boardroom, 95 Bonaventure Avenue, Suite 300. Contact rochelle.baker@med.mun.ca for details.

REPORT SUMMARY

The Research Question:

• Based on the scientific evidence, for what health and developmental concerns should the preschool population of Newfoundland and Labrador be screened?

Study Approach:

• Rapid Evidence Reports provide a succinct and expedited overview of the research evidence on a high-priority research topic selected by decision makers in the province
• For this study, we located systematic review evidence and recent primary studies on population-based, universal preschool screening programs in three areas: vision, hearing, and development.
• The population of interest was children aged three to six years who are not at risk for, or suspected of having, any vision, hearing or developmental concerns.
• We looked screening programs delivered in public health clinics, schools, and daycares.
• Our primary outcome of interest was the effectiveness of screening.

Issues to Consider:

• The concepts of screening and surveillance are often conflated. Decision makers are cautioned to distinguish evidence and recommendations on universal screening programs from the evidence for other types of monitoring.
• Much health and development screening and surveillance focuses on children under the age of three years and not on the preschool population under study in this report.
• Approaches to screening and surveillance are complex and variable. Different jurisdictions focus on different areas of health and development, screen at different ages and intervals, screen in different contexts (public health, primary care, school), and use different screening tools. Adding to this complexity, surveillance practices – which complement screening – are also highly variable.
• In the absence of a mandatory screening program, the preschool population can be difficult to reach depending on geography, access to primary care, and other factors.

Key Findings:

• There is a lack of high-quality evidence on the effectiveness of screening for vision, hearing, and development in preschool populations. Nevertheless, most jurisdictions across the country and internationally operate screening programs for the preschool population.
• Short-term health outcomes are more widely studied than long-term health outcomes or educational outcomes.
• Existing guidelines and recommendations for screening may be of interest to decision makers since they represent different ways of weighing the available evidence and determining the value of preschool screening programs.
• A body of research on the diagnostic accuracy of specific tools shows that there are effective, validated tools for screening preschool populations.  

LINK TO THE REPORT