Evidence map›Paper›PMID 37851079›Full record

ArticleArchives of women's mental health2025

An economic evaluation of universal and targeted case-finding strategies for identifying antenatal depression: a model-based analysis comparing common case-finding instruments.

Elizabeth M Camacho, Gemma E Shields, Emily Eisner, Elizabeth Littlewood, Kylie Watson, Carolyn A Chew-Graham, Dean McMillan, Shehzad Ali, Simon Gilbody

Abstract readComparative Study
In one paragraph

Article in Archives of women's mental health, 2025. 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
–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

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

  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

9 authors.

Elizabeth M CamachoSchool of Health Sciences, University of Manchester, Manchester, UK. elizabeth.camacho@manchester.ac.uk.ORCID http://orcid.org/0000-0001-9574-7710
Gemma E ShieldsSchool of Health Sciences, University of Manchester, Manchester, UK.
Emily EisnerSchool of Health Sciences, University of Manchester, Manchester, UK.
Elizabeth LittlewoodDepartment of Health Sciences, University of York, York, UK.
Kylie WatsonManchester University NHS Foundation Trust, Manchester, UK.
Carolyn A Chew-GrahamSchool of Medicine, Keele University, Keele, UK.
Dean McMillanHull York Medical School and Department of Health Sciences, University of York, York, UK.
Shehzad AliHull York Medical School and Department of Health Sciences, University of York, York, UK.
Simon GilbodyHull York Medical School and Department of Health Sciences, University of York, York, UK.

Funding

Research for Patient Benefit Programme NIHR203474
6 · The paper itself

Abstract

Half of women with depression in the perinatal period are not identified in routine care, and missed cases reflect inequalities in other areas of maternity care. Case finding (screening) for depression in pregnant women may be a cost-effective strategy to improve identification, and targeted case finding directs finite resources towards the greatest need. We compared the cost-effectiveness of three case-finding strategies: no case finding, universal (all pregnant women), and targeted (only pregnant women with risk factors for antenatal depression, i.e. history of anxiety/depression, age < 20 years, and adverse life events). A decision tree model was developed to represent case finding (at around 20 weeks gestation) and subsequent treatment for antenatal depression (up to 40 weeks gestation). Costs include case finding and treatment. Health benefits are measured as quality-adjusted life years (QALYs). The sensitivity and specificity of case-finding instruments and prevalence and severity of antenatal depression were estimated from a cohort study of pregnant women. Other model parameters were derived from published literature and expert consultation. The most cost-effective case-finding strategy was a two-stage strategy comprising the Whooley questions followed by the PHQ-9. The mean costs were £52 (universal), £61 (no case finding), and £62 (targeted case finding). Both case-finding strategies improve health compared with no case finding. Universal case finding is cost-saving. Costs associated with targeted case finding are similar to no case finding, with greater health gains, although targeted case finding is not cost-effective compared with universal case finding. Universal case finding for antenatal depression is cost-saving compared to no case finding and more cost-effective than targeted case finding.

Indexed as

DepressionMass ScreeningPregnancy ComplicationsPregnant PeoplePrenatal CareAdultCost-Benefit AnalysisDecision TreesFemaleHumansPregnancyPrevalenceQuality-Adjusted Life YearsRisk FactorsSensitivity and SpecificityAntenatal depressionCase findingCost-effectiveness

Identifiers

PMID37851079
PMCPMC12283817

What OpenQuestion holds

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Registered trials

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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.