Evidence map›Paper›PMID 36273429›Full record

ArticleUltrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology2023

Cost-effectiveness of ultrasound before non-invasive prenatal screening for fetal aneuploidy.

A N Battarbee, N L Vora, E E Hardisty, D M Stamilio

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 10% 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.

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

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
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

4 authors at 3 institutions in 1 country.

A N BattarbeeCenter for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.ORCID 0000-0002-4837-8059
N L VoraDepartment of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of North Carolina School of Medicine and University of North Carolina Health Care, Chapel Hill, NC, USA.
E E HardistyDepartment of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of North Carolina School of Medicine and University of North Carolina Health Care, Chapel Hill, NC, USA.
D M StamilioDepartment of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA.
University of North Carolina Health Care · USUniversity of Alabama at Birmingham · USWake Forest University · US

Funding

Close the GAP: Glycemic control after Antenatal corticosteroids in women with Pregestational diabetesK23HD103875 · NICHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI BATTARBEE, ASHLEY NICOLE · 2021 to 2025
$826k
NICHD NIH HHS K23 HD103875
6 · The paper itself

Abstract

objectiveTo determine the cost-effectiveness of first-trimester ultrasound before fetal aneuploidy screening with cell-free DNA (cfDNA) compared with screening by cfDNA alone.

methodsA decision analytic model was constructed for 400 000 pregnant individuals with advanced maternal age who desired first-trimester aneuploidy screening with cfDNA in the USA, to compare two screening strategies: (1) cfDNA only and (2) ultrasound performed within 4 weeks before cfDNA. Input parameters included probability of fetal aneuploidy, cfDNA performance, desire for diagnostic testing, pregnancy outcomes, and pregnancy and lifetime costs and utilities. The primary outcome measure was the incremental cost-effectiveness ratio (ICER), in terms of cost in 2020 US dollars (USD) per quality-adjusted life year (QALY) gained. Secondary outcomes included procedure-related loss, pregnancy termination, live birth with aneuploidy, live birth with structural anomaly and stillbirth. Discounting was performed at 3% per year with an estimated maternal lifespan of 81 years starting at the age of 35 years. One-way, multiway and Monte Carlo probabilistic sensitivity analyses were performed. All base-case estimates and ranges of uncertainty were derived from the literature. The willingness-to-pay threshold was set at 100 000 USD per QALY.

resultsIn the base-case analysis, ultrasound before cfDNA screening was more cost-effective than cfDNA screening without pretest ultrasound, with an ICER of 12 588 USD and higher net monetary benefit (24 241 vs 20 466). The strategy involving ultrasound before cfDNA was more costly by 544 USD but also more effective (by 0.04 QALY) compared with cfDNA alone. Base-case results were robust in sensitivity analyses with the strategy involving ultrasound before cfDNA always remaining the most cost-effective approach with the highest net monetary benefit.

conclusionFirst-trimester ultrasound before cfDNA is a more cost-effective strategy for non-invasive prenatal aneuploidy screening compared with cfDNA alone. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Indexed as

Cell-Free Nucleic AcidsPrenatal DiagnosisAdultAneuploidyCost-Benefit AnalysisFemaleHumansInfant, NewbornPregnancyPregnancy OutcomeCell-Free Nucleic Acidsaneuploidycell-free DNAcost-effectivenessnon-invasiveprenatalscreeningultrasound

Identifiers

PMID36273429
PMCPMC10577524
OpenAlexW4307114125

What OpenQuestion holds

Textmetadata
LicenceTDM
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.