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Reduced Costs of Congenital Anomalies from Fetal Ultrasound: Are They Sufficient to Justify Routine Screening in the United States?
Author(s) -
WAITZMAN NORMAN J.,
ROMANO PATRICK S.
Publication year - 1998
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.1998.tb08935.x
Subject(s) - medicine , ultrasound , cost–benefit analysis , obstetrics , fetus , pregnancy , cost analysis , pediatrics , radiology , political science , genetics , biology , law , reliability engineering , engineering
A bstract : No comprehensive benefit‐to‐cost analysis has been performed to date on a policy of routine ultrasound screening for fetal anomalies in the United States. We performed a preliminary benefit‐to‐cost analysis drawing upon our previous research on the cost of birth defects in the United States and upon the literature regarding (1) the sensitivity of ultrasound in detecting congenital anomalies, (2) the rate at which pregnancies are terminated upon detection of fetal anomalies, (3) the number of ultrasounds performed per pregnancy under a routine screening policy, and (4) the average cost of an ultrasound. We assumed a 100% subsequent replacement rate of terminated pregnancies with a normal child, an assumption most favorable to routine screening. The benefit‐to‐cost ratio ranged from .33 to 3, suggesting that a routine screening policy for fetal anomalies is of uncertain net societal benefit. Routine screening may be justified, however, based on standards that elude the methods for establishing societal benefits adopted in this analysis.