Screening for congenital heart malformations in child health centres

The objective of this thesis is to clarify the effectiveness and the efficiency of screening for congenital heart malformations in Dutch child health centres and the possibilities to optimise this prevention programme. To this end the following main questions will be addressed. 1. Does screening for congenital heart malformations, as actually performed in Dutch child health centres, prevent adverse outcomes of these disorders in the short and long run? What would be the answer to this question, if all children were optimally screened? 2. Will screening for congenital heart malformations as actually performed in Dutch child health centres, considering its .test properties and the proportions of false positive and false negative test results, lead to unfavourable effects? What would be the answer to this question, if all children were optimally screened? 3. What costs and savings are involved in the management, including screening in child health centres, of relevant congenital heart malformations? 4. What costs are made per child benefiting from the screening progrannne as actually performed? What would be these costs, if all children were optimally screened? 5. What measures will have to be taken to optiInise the effect of screening for congenital heart malformations in Dutch child health centres?