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Titolo:
Cost-effectiveness of prenatal screening for postpartum thyroiditis
Autore:
Bonds, DE; Freedberg, KA;
Indirizzi:
Wake Forest Univ, Bowman Gray Sch Med, Dept Internal Med, Sect Gen Med, Winston Salem, NC 27103 USA Wake Forest Univ Winston Salem NC USA 27103 , Winston Salem, NC 27103 USA Wake Forest Univ, Bowman Gray Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27103 USA Wake Forest Univ Winston Salem NC USA 27103 , Winston Salem, NC 27103 USA Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Med,Div Gen Internal Med, Boston, MA USA Harvard Univ Boston MA USA Dept Med,Div Gen Internal Med, Boston, MA USA Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 olicy & Management, Boston, MA 02115 USA
Titolo Testata:
JOURNAL OF WOMENS HEALTH & GENDER-BASED MEDICINE
fascicolo: 7, volume: 10, anno: 2001,
pagine: 649 - 658
SICI:
1524-6094(200109)10:7<649:COPSFP>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
DEPENDENT DIABETES-MELLITUS; TERM FOLLOW-UP; DYSFUNCTION; AUTOANTIBODIES; DEPRESSION; ANTIBODIES; PREGNANCY; WOMEN; HYPOTHYROIDISM; ASSOCIATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Bonds, DE Wake Forest Univ, Bowman Gray Sch Med, Gen Internal Med Sect, Bowman Gray Campus,Med Ctr Blvd, Winston Salem, NC 27157 USA Wake Forest UnivBowman Gray Campus,Med Ctr Blvd Winston Salem NC USA 27157
Citazione:
D.E. Bonds e K.A. Freedberg, "Cost-effectiveness of prenatal screening for postpartum thyroiditis", J WOMEN H G, 10(7), 2001, pp. 649-658

Abstract

Five percent of all pregnant women and 25% of pregnant women with insulin-dependent diabetes mellitus (IDDM) develop postpartum thyroiditis (PPT) during the first year after delivery. PPT has significant morbidity and can bepredicted prenatally by the presence of thyroid peroxidase (TPO) antibody. Our objective was to estimate the cost-effectiveness of screening pregnantwomen for the TPO antibody versus the current strategy of no screening test or an alternative strategy of a thyroid-stimulating hormone (TSH) test 6 weeks postpartum. We performed cost-effectiveness analysis using a decisiontree model that accounted for cases of PPT detected, medical outcomes of screening, and costs of screening and care. Hypothetical cohorts of 1000 pregnant women with uncomplicated pregnancies and 1000 pregnant women with IDDM were used to determine direct medical costs, quality-adjusted life years,and cases of PPT detected. The cost of testing 1000 pregnant women for TSHat the 6 week postpartum visit was $75,000, with an effectiveness of 995.2quality-adjusted life years resulting in a cost-effectiveness ratio of $48,000 per quality-adjusted life year. Checking a TPO antibody was more effective (995.5 quality-adjusted life years) but also more expensive ($93,000). The incremental cost-effectiveness ratio of the TPO antibody strategy was $60,000 per quality-adjusted life year. Results were most sensitive to changes in the test characteristics, incidence of disease, and percentage of women with PPT who were symptomatic. A separate analysis for women with IDDM resulted in an incremental cost-effectiveness ratio of $13,000 per quality-adjusted life year for the TSH strategy and $32,000 per quality-adjusted life year for the TPO strategy. Screening for PPT is likely to be reasonably cost-effective and should be considered for inclusion as part of routine pregnancy care.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/12/19 alle ore 14:58:15