Trial reportFertility and sterility2012
A cost-effectiveness analysis of surgical versus medical management of early pregnancy loss.
Trial report in Fertility and sterility, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 5 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Methods for managing miscarriage: a network meta-analysis.The Cochrane database of systematic reviews · 2021Pooled it
- Medical treatment for early fetal death (less than 24 weeks).The Cochrane database of systematic reviews · 2019Pooled it
- Medical treatments for incomplete miscarriage.The Cochrane database of systematic reviews · 2017Pooled it
- Medical treatments for incomplete miscarriage (less than 24 weeks).The Cochrane database of systematic reviews · 2010Pooled it
- Medical treatment for early fetal death (less than 24 weeks).The Cochrane database of systematic reviews · 2006Pooled it
- Medical management of early pregnancy loss is cost-effective compared with office uterine aspiration.American journal of obstetrics and gynecology · 2022Trial
- Cost-effectiveness of Mifepristone Pretreatment for the Medical Management of Nonviable Early Pregnancy: Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2020Trial
- Medical Abortion Provided by Nurse-Midwives or Physicians in a High Resource Setting: A Cost-Effectiveness Analysis.PloS one · 2016Trial
- Serum biomarkers may help predict successful misoprostol management of early pregnancy failure.Reproductive biology · 2015Trial
- Surgical versus expectant management in women with an incomplete evacuation of the uterus after treatment with misoprostol for miscarriage: the MisoREST trial.BMC pregnancy and childbirth · 2013Trial
- Test characteristics of emergency physician-performed point-of-care ultrasound for the diagnosis of intrauterine pregnancy: a systematic review and meta-analysis.Internal and emergency medicine · 2026Article
- Outcomes of incomplete abortion related to treatment modality.Archives of gynecology and obstetrics · 2023Article
- Comparison of the clinical efficacy of surgical versus medical method for first trimester pregnancy termination in Iran: A quasi-experimental research.Journal of education and health promotion · 2023Article
- Economic evaluation of medical versus surgical strategies for first trimester therapeutic abortion: A systematic review.Journal of education and health promotion · 2022Review
- Methadone, Buprenorphine, or Detoxification for Management of Perinatal Opioid Use Disorder: A Cost-Effectiveness Analysis.Obstetrics and gynecology · 2019Article
- Cost Minimization Analysis of Same-Day Long-Acting Reversible Contraception for Adolescents.JAMA network open · 2019Article
- It is cost effective to improve the standard of care for women experiencing miscarriage.The Lancet. Global health · 2019Article
- Medical versus surgical treatment of first trimester spontaneous abortion: A cost-minimization analysis.PloS one · 2019Article
- Off-label use of misoprostol in gynaecology.Facts, views & vision in ObGyn · 2015Article
- Cost and efficacy comparison of in vitro fertilization and tubal anastomosis for women after tubal ligation.Fertility and sterility · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 6 institutions in 1 country.
Funding
Abstract
objectiveTo determine the cost-effectiveness of medical and surgical management of early pregnancy loss.
designAnalyses of cost, effectiveness, and incremental cost-effectiveness ratios and utilities of a multicenter trial with 652 women with first-trimester pregnancy failure randomized to medical or surgical management.
settingAnalysis of data from a multicenter trial. PATIENT(S): Secondary analysis of a multicenter trial. INTERVENTION(S): Cost-effectiveness analysis. MAIN OUTCOME MEASURE(S): Cost and effectiveness of competing treatment strategies. RESULT(S): Cost analysis of treatment demonstrates an increased cost of US$336 for 13% increased efficacy of surgical management. This analysis was sensitive to the probability of an extra office visit, the cost of the visit, and the probability of success. When the surgical arm is divided into outpatient manual vacuum aspiration (MVA) versus inpatient electric vacuum aspiration (EVA), there is an increased cost of $745 for EVA but a decreased cost of $202 for MVA compared with medical management. In general, MVA was found to be more cost-effective than medical management. For treatment of incomplete or inevitable abortion, medical management was found to be less costly and more efficacious. Utilities studies demonstrated that a patient would need to prefer surgery 14% less than medication for its treatment efficacy to be outweighed by the desire to avoid surgery. CONCLUSION(S): Surgical or medical management of early pregnancy failure can be cost effective, depending on the circumstances. Surgery is cost effective and more efficacious when performed in an outpatient setting. For incomplete or inevitable abortion, medical management is cost effective and more efficacious.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.