How Should We Test For Pre-Term Labour? An Economic Model And Cost-Effectiveness Analysis

How Should We Test For Pre-Term Labour? An Economic Model And Cost-Effectiveness Analysis

OBJECTIVES: Develop a prognostic model including quantitative fetal Fibronectin for predicting pre-term labour and assess its cost-effectiveness. METHODS: Based on data derived from four European studies comprising 1,835 women and 171 events of preterm delivery in the QUIDS IPD meta-analysis, a deci...

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Veröffentlicht in:Value in health 2017-10, Vol.20 (9), p.A600
Hauptverfasser: Heggie, R, Boyd, K, Stock, S, Bruijn, M
Format: Artikel
Sprache:eng
Schlagworte:
Childbirth & labor
Clinical practice guidelines
Cost analysis
Diagnosis
Fetuses
Fibronectin
Gestation
Health care expenditures
Health economics
Medical diagnosis
Medical prognosis
Pregnancy
Premature birth
Risk factors
Ultrasound
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Zusammenfassung:OBJECTIVES: Develop a prognostic model including quantitative fetal Fibronectin for predicting pre-term labour and assess its cost-effectiveness. METHODS: Based on data derived from four European studies comprising 1,835 women and 171 events of preterm delivery in the QUIDS IPD meta-analysis, a decision analytic model assessed the cost-effectiveness of alternative prognostic strategies. Costs and probability of correct prognosis were calculated for each strategy, and expressed as net monetary benefit (NMB). Strategies included (i) clinical risk factors alone (CR) (ii) CR plus fetal-fibronectin (fFN), (iii) CR plus quantitative fetal-fibronectin (qfFN), (iv) CR plus transvaginal ultrasound of cervical length (TUCL), (v) CR plus fFN plus TUCL, and (vi) CR plus qfFN plus TUCL. The cost-effectiveness of each strategy is modelled over three gestation periods: extremely premature (
ISSN:1098-3015
1524-4733
DOI:10.1016/j.jval.2017.08.1143