| Title |
Cost-effectiveness of diagnostic tests for threatened preterm labor in singleton pregnancy in France
|
|---|---|
| Published in |
Cost Effectiveness and Resource Allocation, June 2018
|
| DOI | 10.1186/s12962-018-0106-y |
| Pubmed ID | |
| Authors |
Thomas Desplanches, Catherine Lejeune, Jonathan Cottenet, Paul Sagot, Catherine Quantin |
| Abstract |
Previous studies have showed that the early diagnosis of threatened preterm labor decreases neonatal morbidity and mortality, avoids maternal morbidity induced by antepartum bed rest and unnecessary treatment, and reduces costs. Although there are many diagnostic tests, none is clearly recommended by international guidelines. The aim of our study was to compare seven diagnostic methods in terms of effectiveness and cost using a decision analysis model in singleton pregnancy presenting threatened preterm labor, between 24 and 34 weeks of gestation. Seven diagnostic strategies based on individual or combined use of the following tests: cervical length, cervical fibronectin test, cervical interleukin test and protein in maternal serum, were compared using a decision analysis model. Effectiveness was expressed in terms of serious adverse neonatal events avoided (neonatal morbidity and mortality) at the hospital discharge. The economic analysis was performed from the health care system perspective. Deterministic and probabilistic analyses were performed to test the robustness of the model. At 24-34 weeks of gestation, the association of cervical length and qualitative fibronectin was the most efficient strategy dominating all alternatives, reducing the perinatal death or severe neonatal morbidity rate up to 15% and the costs up to 31% according to the gestational age. This result was confirmed by the deterministic sensitivity analyses. The probabilistic analysis showed that the association of cervical length and qualitative fibronectin dominated cervical length < 15 mm in more than 90% of the simulations. The comparison with the other tests revealed more uncertainty. A test using cervical length and qualitative fetal fibronectin appears to be the best diagnostic strategy. Decisions regarding its generalization and funding in France in this population of women should take into account the high, lifetime costs induced by prematurity. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 44 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 44 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 7 | 16% |
| Student > Master | 5 | 11% |
| Student > Bachelor | 4 | 9% |
| Student > Postgraduate | 3 | 7% |
| Student > Doctoral Student | 2 | 5% |
| Other | 6 | 14% |
| Unknown | 17 | 39% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 9 | 20% |
| Nursing and Health Professions | 3 | 7% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 5% |
| Economics, Econometrics and Finance | 2 | 5% |
| Business, Management and Accounting | 2 | 5% |
| Other | 8 | 18% |
| Unknown | 18 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 June 2018.
All research outputs
#4,136,601
of 23,090,520 outputs
Outputs from Cost Effectiveness and Resource Allocation
#132
of 430 outputs
Outputs of similar age
#80,548
of 328,563 outputs
Outputs of similar age from Cost Effectiveness and Resource Allocation
#6
of 10 outputs
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So far Altmetric has tracked 430 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.1. This one has gotten more attention than average, scoring higher than 66% of its peers.
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