Evidence map›Paper›PMID 37133702›Full record

ArticleJournal of thrombosis and thrombolysis2023

Tranexamic acid for the prevention of postpartum hemorrhage: a cost-effectiveness analysis.

Wayde D H Dazelle, Megan K Ebner, Jamil Kazma, Savita N Potarazu, Homa K Ahmadzia

Abstract read
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In one paragraph

Article in Journal of thrombosis and thrombolysis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
4.1field-weighted citation impact, top 7% 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

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

  1. Pooled it
  2. 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

5 authors at 1 institution in 1 country.

Wayde D H DazelleThe George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
Megan K EbnerThe George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
Jamil KazmaDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The George Washington University School of Medicine & Health Sciences, 2300 I St NW, Washington, DC, 20037, USA.
Savita N PotarazuThe George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
Homa K AhmadziaDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The George Washington University School of Medicine & Health Sciences, 2300 I St NW, Washington, DC, 20037, USA. hahmadzia@mfa.gwu.edu.
George Washington University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Postpartum hemorrhage is a significant contributor to maternal mortality worldwide and in the United States. Tranexamic acid (TXA) has been shown to reduce PPH complications although it is not routinely recommended for use as prophylaxis to date. To estimate the cost-effectiveness of alternative risk-dictated strategies utilizing prophylactic tranexamic acid for the prevention of postpartum hemorrhage. We constructed a microsimulation-based Markov decision-analytic model estimating the cost-effectiveness of three alternative risk-dictated strategies for tranexamic acid prophylaxis versus the no prophylaxis in a cohort of 3.8 million pregnant women delivering in the United States. Each strategy differentially modified risk-specific hemorrhage probabilities by preliminary estimates of tranexamic acid's prophylactic efficacy. Outcome measures included incremental costs, quality-adjusted life-years, and outcomes averted. Costs and benefits were considered from the healthcare system and societal perspectives over a lifetime time horizon. All intervention strategies were dominant versus no prophylaxis, implying that they were simultaneously more effective and cost-saving. Prophylaxing delivering women irrespective of hemorrhage risk produced the most favorable results overall, with estimated cost savings greater than $690 million and up to 149,505 PPH cases, 2,933 hysterectomies, and 70 maternal deaths averted, per annual cohort. Threshold analysis suggested that tranexamic acid is likely to be cost-saving for health systems at costs below $190 per gram. Our findings suggest that routine prophylaxis with tranexamic acid would likely result in substantial cost-savings and reductions in adverse maternal outcomes in this context. This study is a cost-effectiveness analysis demonstrating cost-savings and reduction in adverse maternal outcomes with routine tranexamic acid as prophylaxis for post-partum hemorrhage.

Indexed as

Antifibrinolytic AgentsPostpartum HemorrhageTranexamic AcidCost-Benefit AnalysisCost-Effectiveness AnalysisFemaleHumansPregnancyProbabilityUnited StatesAntifibrinolytic AgentsTranexamic AcidCost-effectivenessDecision analysisHemorrhageMaternal mortalityPostpartumTranexamic acid

Identifiers

PMID37133702
OpenAlexW4367833989

What OpenQuestion holds

Textmetadata
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.