Evidence map›Paper›PMID 34016085›Full record

Trial reportBMC public health2021

Cost estimation alongside a multi-regional, multi-country randomized trial of antenatal ultrasound in five low-and-middle-income countries.

B W Bresnahan, E Vodicka, J B Babigumira, A M Malik, F Yego, A Lokangaka, B M Chitah, Z Bauer, H Chavez, J L Moore and 16 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01990625 (Global Network First Look), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.7field-weighted citation impact, top 16% of its field
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.

NCT01990625 nacompletednot on this map

Global Network First Look: A Cluster-Randomized Trial of Ultrasound Use to Improve Pregnancy Outcomes in Low Income Country Settings

TypeinterventionalSponsorNICHD Global Network for Women's and Children's HealthRan2014 to 2016Enrolled45,038ConditionsPregnancy, Eclampsia, Placenta Previa, StillbirthArmsAntenatal Ultrasound Scan
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Article
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

26 authors at 12 institutions in 6 countries.

B W BresnahanDepartment of Radiology, University of Washington, Seattle, WA, USA. bres@uw.edu.
E VodickaDepartment of Pharmacy, University of Washington, Seattle, WA, USA.
J B BabigumiraDepartment of Global Health, University of Washington, Seattle, WA, USA.
A M MalikAga Khan University, Karachi, Pakistan.
F YegoMoi University, Eldoret, Kenya.
A LokangakaKinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo.
B M ChitahUniversity of Zambia, Lusaka, Zambia.
Z BauerDepartment of Radiology, University of Washington, Seattle, WA, USA.
H ChavezUniversity of Francisco Marroquin, Guatemala City, Guatemala.
J L MooreRTI International, Durham, NC, USA.
L P GarrisonDepartment of Pharmacy, University of Washington, Seattle, WA, USA.
J O SwansonDepartment of Radiology, University of Washington, Seattle, WA, USA.
D SwansonDepartment of Radiology, University of Washington, Seattle, WA, USA.
E M McClureRTI International, Durham, NC, USA.
R L GoldenbergColumbia University, New York, NY, USA.
F EsamaiMoi University, Eldoret, Kenya.
A L GarcesINCAP, Guatemala City, Guatemala.
E ChombaUniversity of Zambia, Lusaka, Zambia.
S SaleemAga Khan University, Karachi, Pakistan.
A TshefuKinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo.
C L BoseUniversity of North Carolina, Chapel Hill, NC, USA.
M BausermanUniversity of North Carolina, Chapel Hill, NC, USA.
W CarloUniversity of Alabama Birmingham, Birmingham, AL, USA.
S BucherIndiana University, Indianapolis, IN, USA.
E A LiechtyIndiana University, Indianapolis, IN, USA.
R O NathanDepartment of Radiology, University of Washington, Seattle, WA, USA.
University of Washington · USAga Khan University · PKIndiana University – Purdue University Indianapolis · USMinistry of Public Health · CDMoi University · KERTI International · USUniversity of North Carolina at Chapel Hill · USUniversity of Zambia · ZMColumbia University · USInstitute of Nutrition of Central America and Panama · GTUniversidad Francisco Marroquín · GTUniversity of Alabama at Birmingham · US

Funding

The University of North Carolina-Kinshasa School of Public Health Research Partnership in the Democratic Republic of Congo; a Model for Improving Women'sand Children's Health Through ResearchUG1HD076465 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI MELISSA SCHWEIKHART BAUSERMAN · 2018 to 2026
$5.6M
NICHD NIH HHS UG1 HD076465
6 · The paper itself

Abstract

backgroundImproving maternal health has been a primary goal of international health agencies for many years, with the aim of reducing maternal and child deaths and improving access to antenatal care (ANC) services, particularly in low-and-middle-income countries (LMICs). Health interventions with these aims have received more attention from a clinical effectiveness perspective than for cost impact and economic efficiency.

methodsWe collected data on resource use and costs as part of a large, multi-country study assessing the use of routine antenatal screening ultrasound (US) with the aim of considering the implications for economic efficiency. We assessed typical antenatal outpatient and hospital-based (facility) care for pregnant women, in general, with selective complication-related data collection in women participating in a large maternal health registry and clinical trial in five LMICs. We estimated average costs from a facility/health system perspective for outpatient and inpatient services. We converted all country-level currency cost estimates to 2015 United States dollars (USD). We compared average costs across countries for ANC visits, deliveries, higher-risk pregnancies, and complications, and conducted sensitivity analyses.

resultsOur study included sites in five countries representing different regions. Overall, the relative cost of individual ANC and delivery-related healthcare use was consistent among countries, generally corresponding to country-specific income levels. ANC outpatient visit cost estimates per patient among countries ranged from 15 to 30 USD, based on average counts for visits with and without US. Estimates for antenatal screening US visits were more costly than non-US visits. Costs associated with higher-risk pregnancies were influenced by rates of hospital delivery by cesarean section (mean per person delivery cost estimate range: 25-65 USD).

conclusionsDespite substantial differences among countries in infrastructures and health system capacity, there were similarities in resource allocation, delivery location, and country-level challenges. Overall, there was no clear suggestion that adding antenatal screening US would result in either major cost savings or major cost increases. However, antenatal screening US would have higher training and maintenance costs. Given the lack of clinical effectiveness evidence and greater resource constraints of LMICs, it is unlikely that introducing antenatal screening US would be economically efficient in these settings--on the demand side (i.e., patients) or supply side (i.e., healthcare providers).

trial registrationTrial number: NCT01990625 (First posted: November 21, 2013 on https://clinicaltrials.gov ).

Indexed as

Cesarean SectionDeveloping CountriesChildFemaleHumansPovertyPregnancyPregnant PeoplePrenatal CareAntenatal careCostDeliveryHealth economicsLow-and-middle-income countriesMaternal health

Identifiers

PMID34016085
PMCPMC8135981
OpenAlexW3160418490

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.