Heart disease screening of schoolchildren in Taiwan.
OBJECTIVE
To evaluate the sensitivity of a heart disease screening program for schoolchildren.


METHODS
Prospective cohort study.


METHODS
Taitung County, Taiwan.


METHODS
All first- and fourth-grade elementary school students and first-year junior high school students screened between September 1, 2005, and June 30, 2007. Intervention A 2-level heart disease screening program was undertaken. Level 1 screening included a history questionnaire and phonocardiography and electrocardiography. Level 2 screening consisted of examination by a pediatric cardiologist of all children who had abnormal findings on level 1 screening. A control group comprised children whose level 1 screening results were normal. Children with abnormalities on level 2 screening were referred for a detailed cardiac evaluation.


METHODS
Previously unsuspected heart diseases.


RESULTS
Of 25 816 children undergoing the level 1 screening program, 5330 had positive findings, of whom 5235 underwent level 2 screening, along with 1104 children in the control group. The pediatric cardiologist referred 780 children to the hospital for full evaluation, including 18 controls and 114 patients with a previous diagnosis of heart disease. A total of 292 children, including 2 controls, had evidence of heart disease, which was previously unsuspected in 178 (61.0%). Excluding children with a previous diagnosis of heart disease, the sensitivity of the screening program was 82.6%. The specificity and the positive predictive value were 98.3% and 28.6%, respectively.


CONCLUSIONS
The 2-level heart disease screening program has good sensitivity and detects asymptomatic but potentially life-threatening heart disease in some children.
Yu
Chang-Hsien
CH
Department of Pediatrics, Mackay Memorial Hospital, Taitung, Taiwan.
Lue
Hung-Chi
HC
Wu
Shye-Jao
SJ
Chen
Ming-Ren
MR
D000293:Adolescent; D002648:Child; D004562:Electrocardiography; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000453:epidemiology; D006331:Heart Diseases / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D010701:Phonocardiography; D015995:Prevalence; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013624:Taiwan / Q000453:epidemiology