کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6143780 1594888 2016 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Cost-effectiveness of risk-based screening for cervical length to prevent preterm birth
ترجمه فارسی عنوان
هزینه-اثربخشی غربالگری مبتنی بر ریسک برای طول دهانه رحم برای جلوگیری از زایمان زودرس
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی و دندانپزشکی (عمومی)
چکیده انگلیسی

BackgroundDespite much debate, there is no consensus on whether women without a history of prior spontaneous preterm birth should receive universal cervical length screening. Risk-based screening has been proposed as an alternative to universal cervical length measurement and may represent a more cost-effective approach to preterm birth prevention.ObjectiveWe sought to evaluate the cost-effectiveness of risk-based screening compared to universal cervical length screening or no screening for preterm birth prevention in low-risk women.Study DesignA decision analytic model compared the cost and effectiveness of 3 cervical length screening strategies in a population of women with no prior preterm birth. Risk-based screening, universal screening, and no screening were compared using cost, probability, and utility estimates derived from the existing literature and the incremental cost-effectiveness ratios for each strategy were calculated.ResultsIn the base-case analysis, risk-based screening and universal screening were more effective and less costly than no screening. In comparison to the risk-based strategy, universal screening of the United States population of women without a prior preterm birth (N = 3.5 million annually) would result in 2.19 million more transvaginal ultrasounds, 11,027 more women treated with vaginal progesterone, 913 fewer preterm births <35 weeks gestational age, and 63 fewer neonatal deaths at an additional cost of $51,936,699 annually. Despite costing more, the additional health benefits of universal screening resulted in that strategy being more cost-effective than risk-based screening, with an incremental cost-effectiveness ratio of $21,144 per quality-adjusted life-year.ConclusionIn women without a prior spontaneous preterm birth, universal cervical length screening is cost-effective in comparison to both risk-based screening and no screening.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: American Journal of Obstetrics and Gynecology - Volume 215, Issue 1, July 2016, Pages 100.e1-100.e7
نویسندگان
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