Cost-effectiveness analysis of cervical length measurement and fibronectin testing in women with threatened preterm labor

Gert-Jan van Baaren; Jolande Y. Vis; William A. Grobman; Patrick M. Bossuyt; Brent C. Opmeer; Ben W. Mol

doi:10.1016/j.ajog.2013.06.029

Cost-effectiveness analysis of cervical length measurement and fibronectin testing in women with threatened preterm labor

Gert-Jan van Baaren^*
, Jolande Y. Vis
, William A. Grobman
, Patrick M. Bossuyt
, Brent C. Opmeer
, Ben W. Mol

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: The objective of the study was to evaluate the cost-effectiveness of risk stratification with cervical length (CL) measurement and/or fetal fibronectin (fFN) tests in women with threatened preterm labor between 24 and 34 weeks' gestation.

STUDY DESIGN: We performed a model-based cost-effectiveness analysis to evaluate 7 test-treatment strategies in women with threatened preterm labor from a health care system perspective. Estimates on disease prevalence, costs, and test accuracy were based on medical literature.

RESULTS: We found that additional fFN testing in the case of a CL between 10 and 30 mm is cost saving without compromising neonatal health outcomes, compared with a treat-all strategy or single CL testing. Implementing this strategy could lead to an annual cost saving between (sic)2.8 million and (sic)14.4 million in The Netherlands, a country with about 180,000 deliveries annually.

CONCLUSION: In women with threatened preterm labor between 24 and 34 weeks of gestation, the most cost-effective test strategy uses a combination of CL and fFN testing.

Original language	English
Article number	ARTN 436.e1
Number of pages	8
Journal	American Journal of Obstetrics and Gynecology
Volume	209
Issue number	5
DOIs	https://doi.org/10.1016/j.ajog.2013.06.029
Publication status	Published - Nov 2013

Keywords

cervical length
cost-effectiveness
economic evaluation
fibronectin
preterm labor
RANDOMIZED CONTROLLED-TRIAL
FETAL FIBRONECTIN
ANTENATAL CORTICOSTEROIDS
INTACT MEMBRANES
BIRTH
NIFEDIPINE
RISK
PREGNANCIES
TOCOLYSIS
SINGLETON

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@article{99784eacb21f41dea6000f64284a1137,

title = "Cost-effectiveness analysis of cervical length measurement and fibronectin testing in women with threatened preterm labor",

abstract = "OBJECTIVE: The objective of the study was to evaluate the cost-effectiveness of risk stratification with cervical length (CL) measurement and/or fetal fibronectin (fFN) tests in women with threatened preterm labor between 24 and 34 weeks' gestation.STUDY DESIGN: We performed a model-based cost-effectiveness analysis to evaluate 7 test-treatment strategies in women with threatened preterm labor from a health care system perspective. Estimates on disease prevalence, costs, and test accuracy were based on medical literature.RESULTS: We found that additional fFN testing in the case of a CL between 10 and 30 mm is cost saving without compromising neonatal health outcomes, compared with a treat-all strategy or single CL testing. Implementing this strategy could lead to an annual cost saving between (sic)2.8 million and (sic)14.4 million in The Netherlands, a country with about 180,000 deliveries annually.CONCLUSION: In women with threatened preterm labor between 24 and 34 weeks of gestation, the most cost-effective test strategy uses a combination of CL and fFN testing.",

keywords = "cervical length, cost-effectiveness, economic evaluation, fibronectin, preterm labor, RANDOMIZED CONTROLLED-TRIAL, FETAL FIBRONECTIN, ANTENATAL CORTICOSTEROIDS, INTACT MEMBRANES, BIRTH, NIFEDIPINE, RISK, PREGNANCIES, TOCOLYSIS, SINGLETON",

author = "\{van Baaren\}, Gert-Jan and Vis, \{Jolande Y.\} and Grobman, \{William A.\} and Bossuyt, \{Patrick M.\} and Opmeer, \{Brent C.\} and Mol, \{Ben W.\}",

year = "2013",

month = nov,

doi = "10.1016/j.ajog.2013.06.029",

language = "English",

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journal = "American Journal of Obstetrics and Gynecology",

issn = "0002-9378",

publisher = "Elsevier",

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T1 - Cost-effectiveness analysis of cervical length measurement and fibronectin testing in women with threatened preterm labor

AU - van Baaren, Gert-Jan

AU - Vis, Jolande Y.

AU - Grobman, William A.

AU - Bossuyt, Patrick M.

AU - Opmeer, Brent C.

AU - Mol, Ben W.

PY - 2013/11

Y1 - 2013/11

N2 - OBJECTIVE: The objective of the study was to evaluate the cost-effectiveness of risk stratification with cervical length (CL) measurement and/or fetal fibronectin (fFN) tests in women with threatened preterm labor between 24 and 34 weeks' gestation.STUDY DESIGN: We performed a model-based cost-effectiveness analysis to evaluate 7 test-treatment strategies in women with threatened preterm labor from a health care system perspective. Estimates on disease prevalence, costs, and test accuracy were based on medical literature.RESULTS: We found that additional fFN testing in the case of a CL between 10 and 30 mm is cost saving without compromising neonatal health outcomes, compared with a treat-all strategy or single CL testing. Implementing this strategy could lead to an annual cost saving between (sic)2.8 million and (sic)14.4 million in The Netherlands, a country with about 180,000 deliveries annually.CONCLUSION: In women with threatened preterm labor between 24 and 34 weeks of gestation, the most cost-effective test strategy uses a combination of CL and fFN testing.

AB - OBJECTIVE: The objective of the study was to evaluate the cost-effectiveness of risk stratification with cervical length (CL) measurement and/or fetal fibronectin (fFN) tests in women with threatened preterm labor between 24 and 34 weeks' gestation.STUDY DESIGN: We performed a model-based cost-effectiveness analysis to evaluate 7 test-treatment strategies in women with threatened preterm labor from a health care system perspective. Estimates on disease prevalence, costs, and test accuracy were based on medical literature.RESULTS: We found that additional fFN testing in the case of a CL between 10 and 30 mm is cost saving without compromising neonatal health outcomes, compared with a treat-all strategy or single CL testing. Implementing this strategy could lead to an annual cost saving between (sic)2.8 million and (sic)14.4 million in The Netherlands, a country with about 180,000 deliveries annually.CONCLUSION: In women with threatened preterm labor between 24 and 34 weeks of gestation, the most cost-effective test strategy uses a combination of CL and fFN testing.

KW - cervical length

KW - cost-effectiveness

KW - economic evaluation

KW - fibronectin

KW - preterm labor

KW - RANDOMIZED CONTROLLED-TRIAL

KW - FETAL FIBRONECTIN

KW - ANTENATAL CORTICOSTEROIDS

KW - INTACT MEMBRANES

KW - BIRTH

KW - NIFEDIPINE

KW - RISK

KW - PREGNANCIES

KW - TOCOLYSIS

KW - SINGLETON

U2 - 10.1016/j.ajog.2013.06.029

DO - 10.1016/j.ajog.2013.06.029

M3 - Article

C2 - 23791688

SN - 0002-9378

VL - 209

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

IS - 5

M1 - ARTN 436.e1

ER -

Cost-effectiveness analysis of cervical length measurement and fibronectin testing in women with threatened preterm labor

Abstract

Keywords

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