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Cost-effectiveness of the non-pneumatic anti-shock garment (NASG): evidence from a cluster randomized controlled trial in Zambia and Zimbabwe

Overview of attention for article published in BMC Health Services Research, January 2015
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (63rd percentile)
  • Above-average Attention Score compared to outputs of the same age and source (58th percentile)

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3 tweeters
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2 Facebook pages

Citations

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6 Dimensions

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36 Mendeley
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Title
Cost-effectiveness of the non-pneumatic anti-shock garment (NASG): evidence from a cluster randomized controlled trial in Zambia and Zimbabwe
Published in
BMC Health Services Research, January 2015
DOI 10.1186/s12913-015-0694-6
Pubmed ID
Authors

Janelle Downing, Alison El Ayadi, Suellen Miller, Elizabeth Butrick, Gricelia Mkumba, Thulani Magwali, Christine Kaseba-Sata, James G Kahn

Abstract

BackgroundObstetric hemorrhage is the leading cause of maternal mortality, particularly in low resource settings where delays in obtaining definitive care contribute to high rates of death. The non-pneumatic anti-shock garment (NASG) first-aid device has been demonstrated to be highly cost-effective when applied at the referral hospital (RH) level. In this analysis we evaluate the incremental cost-effectiveness of early NASG application at the Primary Health Center (PHC) compared to later application at the RH in Zambia and Zimbabwe.MethodsWe obtained data on health outcomes and costs from a cluster-randomized clinical trial (CRCT) and participating study hospitals. We translated health outcomes into disability-adjusted life years (DALYs) using standard methods. Econometric regressions estimated the contribution of earlier PHC NASG application to DALYs and costs, varying geographic covariates (country, referral hospital) to yield regression models best fit to the data. We calculated cost-effectiveness as the ratio of added costs to averted DALYs for earlier PHC NASG application compared to later RH NASG application.ResultsOverall, the cost-effectiveness of early application of the NASG at the primary health care level compared to waiting until arrival at the referral hospital was $21.78 per DALY averted ($15.51 in added costs divided by 0.712 DALYs averted per woman, both statistically significant). By country, the results were very similar in Zambia, though not statistically significant in Zimbabwe. Sensitivity analysis suggests that results are robust to a per-protocol outcome analysis and are sensitive to the cost of blood transfusions.ConclusionsEarly NASG application at the PHC for women in hypovolemic shock has the potential to be cost-effective across many clinical settings. The NASG is designed to reverse shock and decrease further bleeding for women with obstetric hemorrhage; therefore, women who have received the NASG earlier may be better able to survive delays in reaching definitive care at the RH and recover more quickly from shock, all at a cost that is highly acceptable.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 36 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Ethiopia 1 3%
Unknown 35 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 10 28%
Researcher 7 19%
Student > Postgraduate 3 8%
Student > Ph. D. Student 3 8%
Other 2 6%
Other 7 19%
Unknown 4 11%
Readers by discipline Count As %
Medicine and Dentistry 13 36%
Nursing and Health Professions 5 14%
Business, Management and Accounting 2 6%
Environmental Science 2 6%
Social Sciences 2 6%
Other 6 17%
Unknown 6 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. 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 25 July 2017.
All research outputs
#5,944,701
of 11,516,709 outputs
Outputs from BMC Health Services Research
#1,812
of 3,701 outputs
Outputs of similar age
#89,868
of 251,925 outputs
Outputs of similar age from BMC Health Services Research
#30
of 72 outputs
Altmetric has tracked 11,516,709 research outputs across all sources so far. This one is in the 47th percentile – i.e., 47% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,701 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.0. This one has gotten more attention than average, scoring higher than 50% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 251,925 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 63% of its contemporaries.
We're also able to compare this research output to 72 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 58% of its contemporaries.