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MONDAY, March 8 (HealthDay News) -- Electrocardiogram screening to check for heart problems in hyperactive children before prescribing stimulant medications may help identify those at risk, but is only borderline cost-effective compared to the current practice of taking a patient history and doing a physical examination, a new study shows.
Stimulant medications -- such as Ritalin, Concerta and Adderall -- that are used to treat attention-deficit/hyperactivity disorder boost pulse rate and may increase the risk of sudden cardiac death in children with some types of heart conditions.
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In this study, U.S. National Institutes of Health researchers used a cost-effectiveness model to compare three strategies:
- Strategy 1. Current standard of care -- a history, physical exam and referral of children with potential problems to a cardiologist.
- Strategy 2. Conduct an ECG only on children with a normal history and physical, and refer those with suspicious findings on either the history/physical or ECG to a cardiologist. Compared to strategy 1, this approach would save an additional 13 children from sudden cardiac death for every 400,000 children screened. The cost would be $1.6 million per additional life saved and an estimated $39,300 per quality-adjusted life year saved.
- Strategy 3. Conduct an ECG on all children, as well as a history and physical, and refer only those with an abnormal ECG to a cardiologist. Compared to strategy 1, this approach would also save an additional 13 children from sudden cardiac death for every 400,000 who are screened. The cost would be $1.2 million per additional life saved and about $27,200 per quality-adjusted life year saved.
Lives typically would be saved by barring at-risk children from playing sports, the researchers said.
"We're not making a recommendation, but providing one type of analysis so others can determine what makes sense in the real world," study co-author Dr. Jonathan Kaltman, a medical officer in the heart development and structural diseases branch of the U.S. National Heart, Lung, and Blood Institute, said in a news release.
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-- Robert Preidt
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