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WS06‐09Prenatal detection of congenital heart disease: the need for a cost‐effectiveness analysis
Author(s) -
Paladini D.,
Teodoro A.,
Lamberti A.,
Arienzo M.,
Martinelli P.
Publication year - 2000
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2000.00009-1-43.x
Subject(s) - medicine , psychological intervention , heart disease , incidence (geometry) , in utero , salary , cardiology , emergency medicine , pregnancy , fetus , physics , psychiatry , biology , political science , law , optics , genetics
Background Recent reports have shown a significantly improved survival for complex congenital heart disease (CHD) when detected antenatally. This has further substantiated the need to detect CHD in utero . Since the performance of the 4‐chamber view as a screening tool is rather insufficient, the issue is now to find more effective and not too expensive alternative methods to reach this aim. Method The cost‐effectiveness analysis (CEA) is an efficient method to assess health outcomes and resource costs of health interventions. We have applied this tool to prenatal detection of CHD, comparing 3 models: (1) 4‐chamber view at level I; (2) outflow tracts at level I; (3) Outflow tracts at level II. To perform the analysis we have made the following assumptions: (1) the incidence of CHD at 20 weeks is 10/1000; (2) the percentage of severe CHD is 40%; (3) the monthly salary are 2500 USD and 3500 USD for level I and level II operators, respectively; (4) detection rate for CHD detectable on the 4‐chamber view and on outflows only are 35%/20%, 60%/60%, and 90%/90% for the three options (level I 4‐chamber, level I outflows, level II outflows). Results and conclusions Based on the forementioned assumptions, the costs for (1) a diagnosis of CHD; (2) a diagnosis of severe CHD; (3) TOP of any CHD; TOP of a severe CHD are reported below. These results, which were also submitted to sensitivity analyses, will be discussed.CostsOutcome Level I 4‐ch. Level I
Outflows Level II
Outflows Det. Any CHD 1796 USD 1157 USD 324 USD Det Severe CHD 6510 USD 2894 USD 810 USD TOP Any CHD 5314 USD 2893 USD 810 USD TOP Severe CHD 9300 USD 4133 USD 1157 USD