Evidence map›Paper›PMID 33127635›Full record

SynthesisBMJ open2020

Costing the impact of interventions during pregnancy in the UK: a systematic review of economic evaluations.

Sophie Relph, Louisa Delaney, Alexandra Melaugh, Matias C Vieira, Jane Sandall, Asma Khalil, Dharmintra Pasupathy, Andy Healey, DESiGN Trial Team

Abstract readSystematic Review
In one paragraph

Synthesis in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

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

  1. Pooled it
  2. Article
  3. Observational
  4. Improving antenatal detection of small-for-gestational-age fetus: economic evaluation of Growth Assessment Protocol.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2022
    Article
  5. Article
  6. Review
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

9 authors.

Sophie RelphDepartment of Women and Children's Health, King's College London, St Thomas' Hospital, London, UK sophie.relph@kcl.ac.uk.ORCID 0000-0002-2007-9647
Louisa DelaneyDepartment of Women and Children's Health, King's College London, St Thomas' Hospital, London, UK.
Alexandra MelaughHealth Improvement: Alcohol, Drugs, Tobacco and Justice Division, Public Health England, London, UK.
Matias C VieiraDepartment of Women and Children's Health, King's College London, St Thomas' Hospital, London, UK.ORCID 0000-0002-8076-4275
Jane SandallDepartment of Women and Children's Health, King's College London, St Thomas' Hospital, London, UK.
Asma KhalilFetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK.
Dharmintra PasupathyDepartment of Women and Children's Health, King's College London, St Thomas' Hospital, London, UK.
Andy HealeyHealth Service and Population Research, King's College London, De Crespigny Park, London, UK.
DESiGN Trial Team

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of this review was to summarise the current evidence on the costing of resource use within UK maternity care, in order to facilitate the estimation of incremental resource and cost impacts potentially attributable to maternity care interventions.

methodsA systematic review of economic evaluations was conducted by searching Medline, the Health Management Information Consortium, the National Health Service (NHS) Economic Evaluations Database, CINAHL and National Institute for Health and Care Excellence (NICE) guidelines for economic evaluations within UK maternity care, published between January 2010 and August 2019 in the English language. Unit costs for healthcare activities provided to women within the antenatal, intrapartum and postnatal period were inflated to 2018-2019 prices. Assessment of study quality was performed using the Quality of Health Economic Analyses checklist.

resultsOf 5084 titles or full texts screened, 37 papers were included in the final review (27 primary research articles, 7 review articles and 3 economic evaluations from NICE guidelines). Of the 27 primary research articles, 21 were scored as high quality, 3 as medium quality and 3 were low quality. Variation was noted in cost estimates for healthcare activities throughout the maternity care pathway: for midwife-led outpatient appointment, the range was £27.34-£146.25 (mean £81.78), emergency caesarean section, range was £1056.44-£4982.21 (mean £3508.93) and postnatal admission, range was £103.00-£870.10 per day (mean £469.55).

conclusionsWide variation exists in costs applied to maternity healthcare activities, resulting in challenges in attributing cost to maternity activities. The level of variation in cost calculations is likely to reflect the uncertainty within the system and must be dealt with by conducting sensitivity analyses. Nationally agreed prices for granular unit costs are needed to standardise cost-effectiveness evaluations of new interventions within maternity care, to be used either for research purposes or decisions regarding national intervention uptake. PROSPERO REGISTRATION NUMBER: CRD42019145309.

Indexed as

Maternal Health ServicesState MedicineCesarean SectionCost-Benefit AnalysisFemaleHumansPregnancyUnited Kingdomantenatalhealth economicsmaternal medicineobstetrics

Identifiers

PMID33127635
PMCPMC7604861

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.