Evidence map›Paper›PMID 28212958›Full record

SynthesisValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2017

Economic Evaluations Comparing a Trial of Labor with an Elective Repeat Cesarean Delivery: A Systematic Review.

Anna Joy Rogers, Nathaniel G Rogers, Meredith L Kilgore, Akila Subramaniam, Lorie M Harper

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Economic Evaluations Comparing a Trial of Labor with an Elective Repeat Cesarean Delivery: A Systematic Review.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2017
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anna Joy RogersDepartment of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: rogersaj@uab.edu.
Nathaniel G RogersDepartments of Medicine and Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA.
Meredith L KilgoreDepartment of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Akila SubramaniamMaternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Lorie M HarperMaternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

Funding

UAB Center for Clinical and Translational Science (CCTS)UL1TR001417 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI KIMBERLY, ROBERT P. · 2015 to 2018
$31.4M
MEDICAL SCIENTIST TRAINING PROGRAMT32GM008361 · NIGMS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI YACOUBIAN, TALENE ALENE · 1992 to 2024
$16.8M
UAB Center for Clinical and Translational Sciences (CCTS)TL1TR001418 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SAAG, KENNETH G · 2015 to 2018
$2.1M
NCATS NIH HHS TL1 TR001418NCATS NIH HHS UL1 TR001417NIGMS NIH HHS T32 GM008361
6 · The paper itself

Abstract

backgroundFor women who have had a previous low transverse cesarean delivery, the decision to undergo a trial of labor after cesarean (TOLAC) or an elective repeat cesarean delivery (ERCD) has important clinical and economic ramifications.

objectivesTo evaluate the cost-effectiveness of the alternative choices of a TOLAC and an ERCD for women with low-risk, singleton gestation pregnancies.

methodsWe searched EMBASE, MEDLINE, CINAHL, Cochrane Library, EconLit, and the Cost-Effectiveness Analysis Registry with no language, publication, or date restrictions up until October 2015. Studies were included if they were primary research, compared a TOLAC with an ERCD, and provided information on the relative cost of the alternatives. Abstracts and partial economic evaluations were excluded.

resultsOf 310 studies initially reviewed, 7 studies were included in the systematic review. In the base-case analyses, 4 studies concluded that TOLAC was dominant over ERCD, 1 study found ERCD to be dominant, and 2 studies found that although TOLAC was more costly, it offered more benefits and was thus cost-effective from a population perspective when considering societal willingness to pay for better outcomes. In sensitivity analyses, cost-effectiveness was found to be dependent on a high likelihood of TOLAC success, low risk of uterine rupture, and low relative cost of TOLAC compared with ERCD.

conclusionsFor women who are likely to have a successful vaginal delivery, routine ERCD may result in excess morbidity and cost from a population perspective.

Indexed as

Trial of LaborCesarean Section, RepeatCost-Benefit AnalysisFemaleHumansModels, EconometricPregnancyReproducibility of ResultsVaginal Birth after Cesareancesarean deliverycosteconomicseffectivenesselective surgical procedurespregnancy complicationsprobabilityquality-adjusted life-yearstrial of laborutilityvaginal birth after cesarean

Identifiers

PMID28212958
PMCPMC5319694

What OpenQuestion holds

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Registered trials

None linked

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.