EUSCREEN Paediatric Screening Questionnaire

EUSCREEN Paediatric Screening Questionnaire

(Please provide exact affiliation for publication)
If national data differ from regional data and you are well informed about the differences, you will need to fill out two forms, or two Country Representatives have to fill out two forms. For instance, in the United Kingdom four Country Representatives may be needed to fill out four forms for Northern Ireland, Scotland, Wales and England. If you fill out the questionnaire for a region, it is tacitly assumed that all answers apply to the selected region. Otherwise it should be explicitly mentioned. For instance, mortality rate is usually reported per country. Please specify which region at "Other".

Domain 1: Demography and Epidemiology

General questions

Use for example government website or WHO/ World Bank website.
Use for example government website.
The response to this question may differ per country. For instance, for the Netherlands 80,9% are Nederlands, 2,4% Indonsian, 2,4% German, 2,2% Turkish, 2,0% Surinamese, 1,9% Maroccan, 0,8% Antillian en Aruban and 6,0% Other.
Use for example governmental website or Worldbank website.
Please also provide the year that you are referring to (e.g. 2014)
Please also provide the year (e.g. 2014)
Please also provide the year (e.g. 2014)
Please specify male or female or both. If you fill out the questionnaire for a region, it is tacitly assumed that all answers apply to the selected region. Otherwise it should be explicitly mentioned.
If available, please specify per age group. If you fill out the questionnaire for a region, it is tacitly assumed that all answers apply to the selected region. Otherwise it should be explicitly mentioned.

Vision questions

Please note that the question here is whether the child had amblyopia at the time of diagnosis, regardless whether it has been treated successfully since. Amblyopia at the time of diagnosis is defined here as an initial visual-acuity difference of 2 logMAR lines or worse between the two eyes with an identified cause of amblyopia and absence of organic disorder. Please specify when additional criteria are used like a threshold visual acuity for the amblyopic eye.
What criteria do you use for persistent amblyopia, like a threshold of visual acuity of the worse eye? (e.g. 1.0% persistent amblyopia, VA in worse eye < 0.5 or > 0.3 logMAR)
Please specify the definition used for strabismus.
Please specify incidence per age year if possible.

Hearing questions

Permanent bilateral hearing loss ≥ 40 dB = hearing loss in the best hearing ear ≥ 40 dB
Please also provide age. Please indicate whether children identified in the newborn period are included or not.
Please also provide age. Please indicate whether children identified in the newborn period are included or not.
Please also provide age. Please indicate whether children identified in the newborn period are included or not.
Please also provide age. Please indicate whether children identified in the newborn period are included or not.
Please also provide age. Please indicate whether children identified in the newborn period are included or not.
Please also provide age. Please indicate whether children identified in the newborn period are included or not.

Domain 2: Administration and General background

General questions

Example professions: Nurse, midwife, paediatrician, youth health care doctor, youth health care nurse, GP, specialist nurse, assistant nurse, practice assistant, health care support worker, lay screener. It may be a combination of several of these, please provide proportions of participation in that case.
Please specify currency. Please provide professions and salary costs per year, per person (in full time equivalent) or for the whole service. If unknown, please answer next question (salary cost per hour).
Please specify currency. Please provide professions and salary costs per hour.
Please provide professions.
In the Netherlands, for instance, nurses have been additionally trained to become youth-healthcare nurses to carry out part of the screening. Please provide professions.
For instance, how much does it cost to train a medical doctor to become a preventive healthcare doctor? If the total costs are unknown, would it be possible to provide, for instance, figures about the university educational fee, the contribution from the government, additional costs like books, etcetera.
Please provide answer per profession.
Please provide answer per profession.
Please provide answer per profession.
Please specify certificate of accreditation. Please provide answer per profession.

Vision questions

Please specify currency. Please provide professions and salary costs per year, per person (in full time equivalent) or for the whole service. If unknown, please answer next question (salary cost per hour).
Please specify currency. Please provide professions and salary costs per hour.
Please provide professions.
Like nurses or practice assistance. Please provide professions.
If the total costs are unknown, would it be possible to provide, for instance, figures about the university educational fee, the contribution from the government, additional costs like books etcetera.
Please provide answer per profession.
Please provide answer per profession.
Please provide answer per profession.
Please specifiy certificate of accreditation. Please provide answer per profession.

Hearing questions

Please specify currency. Please provide professions and salary costs per year, per person (in full time equivalent) or for the whole service. If unknown, please answer next question (salary cost per hour).
Please provide professions and salary costs per hour with currency
Please provide professions.
Like nurses or practice assistance. Please provide professions.
If the total costs are unknown, would it be possible to provide, for instance, figures about the university educational fee, the contribution from the government, additional costs like books etcetera.
Please provide answer per profession. Profession examples: Audiologist, audiologist assistant, ENT physician, specialist nurse, assistant nurse
Please provide answer per profession. Profession examples: Audiologist, audiologist assistant, ENT physician, specialist nurse, assistant nurse
Please provide answer per profession.

Domain 3: Existing screening systems

General questions

Apart from regional differences (e.g. Scotland, Northern Ireland, Wales, England), also local differences are possible. For instance, the Netherlands has one guideline for general, vision and hearing screening, but the Netherlands is split up in 27 youth healthcare areas and some vision tests are omitted in some local areas. Please specify regions and local areas precisely.
Please provide information about differences in coverage, personnel, tests and funding. Differences between individual tests can be entered in Domain 5: Tests
Please provide currency.
Please provide currency.
Please email any available guidelines to euscreen2020@gmail.com even if they are only available in your own language.
If yes, please answer the following two questions as well
Please specify.

Vision questions

Apart from regional differences (e.g. Scotland, Northern Ireland, Wales, England), also local differences are possible. For instance, the Netherlands has one guideline for general, vision and hearing screening, but the Netherlands is split up in 27 youth healthcare areas and some vision tests are omitted in some local areas. Please specify regions and local areas precisely.
Please specify.
Please specify.
Please provide information about differences in coverage, personnel, tests and funding. Differences between individual tests can be entered in Domain 5.
Please provide currency
Please provide currency.
E.g. professional body for ophthalmologists/orthoptists, public health organisation, local government, national government.
Please email any available guidelines to euscreen2020@gmail.com even if they are only available in your own language.
If yes, please answer the following question as well
If yes, please answer the following 2 questions as well
Please specify
If yes, please provide details were we can find that data
If yes, please provide details were we can find that data
Please specify by age if applicable. e.g. 2 line VA difference
Please specify by age, if screened repeatedly. e.g. 2 line VA difference

Hearing questions

Apart from regional differences (e.g. Scotland, Northern Ireland, Wales, England), also local differences are possible. For instance, the Netherlands has one guideline for general, vision and hearing screening, but the Netherlands is split up in 27 youth healthcare areas and some vision tests are omitted in some local areas. Please specify regions and local areas precisely.
Please specify.
Please specify.
Please specify which region and local areas.
Please specify.
Please provide information about differences in coverage, personnel, tests and funding
Please provide currency
Please provide currency.
Please provide currency.
Please specify unilateral or bilateral or both . E.g. hearing loss ≥25dB or ≥40dB or ≥ 80dB
Please provide information about differences in coverage, personnel, tests and funding
Please provide currency
Please provide currency.
Please specify unilateral or bilateral or both. E.g. hearing loss ≥25dB or ≥40dB or ≥ 80dB
Please provide information about differences in age, coverage, personnel, tests and funding
Please provide currency
Please provide currency.
Please provide currency.
Please specify unilateral, bilateral or both. E.g. hearing loss ≥25dB or ≥40dB or ≥ 80dB
e.g. professional body for audiologist/ENT specialists, public health organization, government
If yes, please answer the following two questions as well
Please provide currency.
If yes, please provide details were we can find that data

Domain 4: Coverage/Attendance

General questions

Please send it to euscreen2020@gmail.com , even if it written in your own language
Please specify per age groups
Coverage is defined as the percentage of children in the population who are eligible for screening at a particular point in time, who have had a test with a recorded result within a specific period of time.
When 100 children and their parents are invited, what number or percentage of children does attend to be screened

Vision questions

Please send it to euscreen2020@gmail.com , even if it written in your own language
Coverage is defined as the percentage of children in the population who are eligible for screening at a particular point in time, who have had a test with a recorded result within a specific period of time.
When 100 children and their parents are invited, what number or percentage of children does attend to be screened
“What percentage of children are offered at least one visual acuity measurement before the age of 7”?
“What percentage of children attend for at least one visual acuity measurement before the age of 7”?

Hearing questions

Please send it to euscreen2020@gmail.com , even if it written in your own language
e.g. weight, age
Please provide percentage if applicable
Coverage is defined as the percentage of children in the population who are eligible for screening at a particular point in time, who have had a test with a recorded result within a specific period of time.
When 100 children and their parents are invited, what number or percentage of children does come to be screened
NICU babies excluded.Please also provide the year (e.g. 2014). Coverage is defined as the percentage of children in the population who are eligible for screening at a particular point in time, who have had a test with a recorded result within a specific period of time.
NICU babies excluded. Please also provide the year (e.g. 2014). Attendance rate, when 100 children and their parents are invited, what number or percentage of children does attend to be screened
If possible, specify for age under 2, age 2-4 and age 4-6
Age under 2, age 2-4 and age 4-6
Age under 2, age 2-4 and age 4-6
After neonatal
Please also provide the year (e.g. 2014). Coverage is defined as the percentage of children in the population who are eligible for screening at a particular point in time, who have had a test with a recorded result within a specific period of time.
Please also provide the year (e.g. 2014). Attandance rate: when 100 children and their parents are invited, what number or percentage of children does come to be screened

Domain 5: Tests

General questions

Please specify age per test

Vision questions

What tests are performed at what age?
Please specify per age when different
E.g. Ophthalmologist, orthoptist, optometrist. Please specify per age group if applicable
E.g. Ophthalmologist, orthoptist, optometrist. Please specify per age group if applicable
Details should be supplied in the following questions
What tests are performed at what age?
What tests are performed at what age?
Please specify per age group
Please specify age categories precisely, in months.
Please specify which chart is used
Please specify which chart is used
E.g. nurse at 3 years old and youth health care physician at 4 years old
If more profesions prescribe glasses, please specify.
Please specify currency
Please specify currency

Hearing questions

What tests are performed at what age?
Tick all that apply
Tick all that apply
Please specify per test and what criteria
What test is done at what age?
What test is done at what age?
What tests are performed at what age?
Please specify abnormal or inconclusive or both
OAE, aABR, ASSR and please specify the currency
OAE, aABR, ASSR and please specify the currency
OAE, aABR, ASSR
OAE, aABR, ASSR and please specify the currency

Domain 6: Follow-up and Diagnosis

General questions

Is data collected on follow up after screening?

Vision questions

e.g. retinoblastoma, cataract, glaucoma, per year.
Screened children only
Both screened and unscreened
Screened children only
Both screened and unscreened
E.g. strabismus a third, refractive amblyopia a third, etc.
Is data collected on follow up after an abnormal screening result?

Hearing questions

Please send it to euscreen2020@gmail.com

Domain 7: Treatment availability

Vision questions

Please specify cost of visits to orthoptists and ophthalmologists, how many visits are needed, cost of patching, cost of glasses.
Please specify cost of visits to orthoptists and ophthalmologists, how many visits are needed, cost of patching, cost of glasses.
Please specify cost of visits to orthoptists and ophthalmologists, how many visits are needed.
Specify per category
Please specify currency.
Please itemize type of support, costs per hour support and how it is financed.

Hearing questions

Please specify currency
Please specify currency
Please specify, consults cost, how many consults needed for follow up and what is the cost of hearing aid, cochlear implant, bone conductive device
Please specify, consults cost, how many consults needed for follow up and what is the cost of hearing aid, cochlear implant, bone conductive device
Please itemize type of support, costs per hour support and how it is financed.

Domain 8: Cost and Benefit

General questions

Vision questions

Hearing questions

Domain 9: Adverse effects

Vision questions

Or estimate: how often in your practice do you see a child with amblyopia missed at screening?
Or estimate: What percentage of children referred for amblyopia after screening do not have amblyopia?
If applicable, please provide it per test per age category
If applicable, please provide it per test per age category

Hearing questions

Or estimate: how often in your practice do you see a baby with hearing loss missed at neonatal hearing screening?
Or estimate: What percentage of babies referred after neonatal hearing screening do not have a hearing loss?
Or estimate: how often in your practice do you see a child with hearing loss missed at preschool hearing screening?
Or estimate: What percentage of children referred after preschool hearing screening do not have a hearing loss?
Or, what percentage of all babies with a ‘refer’ result is indeed diagnosed with a hearing loss?
Or, what percentage of all babies with a hearing loss have a test result ‘refer’? Or estimate: how often in your practice do you see a baby with hearing loss missed at neonatal hearing screening?
Or, what percentage of all infants with a ‘refer’ result is indeed diagnosed with a hearing loss?
Or, what percentage of all infants with a hearing loss have a test result ‘refer’? Or estimate: how often in your practice do you see a baby with hearing loss missed at neonatal hearing screening?
Or, what percentage of all infants without hearing loss (numbers ‘pass’ plus numbers false ‘refers’) had a test result ‘pass’?
Or, what percentage of all children with a ‘refer’ result is indeed diagnosed with a hearing loss?
Or, what percentage of all children with a hearing loss have a test result ‘refer’?
Or, what percentage of all children without hearing loss (numbers ‘pass’ plus numbers false ‘refers’) had a test result ‘pass’?