Matches in SemOpenAlex for { <https://semopenalex.org/work/W4200418084> ?p ?o ?g. }
Showing items 1 to 67 of
67
with 100 items per page.
- W4200418084 endingPage "S434" @default.
- W4200418084 startingPage "S434" @default.
- W4200418084 abstract "While the use of physical-exam indicated cerclage in twin gestations is debated, a recent randomized trial found that cerclage in twin pregnancies with asymptomatic cervical dilation reduces preterm birth and infant mortality. In this study, we evaluated both the potential clinical benefits and cost-effectiveness of cerclage vs. no cerclage in twin pregnancies with asymptomatic cervical dilation. We used TreeAge to construct a decision-analytic model comparing outcomes between those who received a cerclage to those who did not. Our theoretical cohort contained 1,500 patients, the approximate number of twin pregnancies with asymptomatic cervical dilation per year in the U.S. Outcomes were previable delivery, preterm birth at ≤ 27 weeks, ≤ 31 weeks, ≤ 33 weeks, and ≥ 34 weeks of gestation, infant mortality, and neurodevelopmental delay (NDD). All values were derived from the literature. We discounted QALYs at a rate of 3% and used an incremental cost effectiveness ratio (ICER) threshold of $100,000/QALY. We performed sensitivity analyses to assess the model’s robustness. In our theoretical cohort of 1,500 twin pregnancies, cerclage was associated with a decrease in 885 previable deliveries and 1,710 infant deaths, and an additional 60 NDD (Table 1). There was an increase in viable deliveries at all gestational age ranges in the cerclage arm. Despite increased costs, cerclage increased QALYs and was a cost-effective strategy with an ICER of $811/QALY. Sensitivity analyses demonstrated that cerclage remained cost effective until patients without a cerclage were at a low risk of previable birth (5% from baseline 70%). The cerclage strategy remained cost-effective among all reasonable costs, including a cost of cerclage up to $20,000. In this study, cerclage was a clinically beneficial and cost-effective strategy to reduce previable delivery and infant death. Providers should consider recommending cerclage to individuals with twin pregnancies and asymptomatic cervical dilation to improve maternal and neonatal outcomes." @default.
- W4200418084 created "2021-12-31" @default.
- W4200418084 creator A5006906657 @default.
- W4200418084 creator A5023068997 @default.
- W4200418084 creator A5059266942 @default.
- W4200418084 creator A5068828298 @default.
- W4200418084 date "2022-01-01" @default.
- W4200418084 modified "2023-09-23" @default.
- W4200418084 title "Cerclage in twin pregnancy: a cost-effectiveness analysis" @default.
- W4200418084 doi "https://doi.org/10.1016/j.ajog.2021.11.721" @default.
- W4200418084 hasPublicationYear "2022" @default.
- W4200418084 type Work @default.
- W4200418084 citedByCount "0" @default.
- W4200418084 crossrefType "journal-article" @default.
- W4200418084 hasAuthorship W4200418084A5006906657 @default.
- W4200418084 hasAuthorship W4200418084A5023068997 @default.
- W4200418084 hasAuthorship W4200418084A5059266942 @default.
- W4200418084 hasAuthorship W4200418084A5068828298 @default.
- W4200418084 hasBestOaLocation W42004180841 @default.
- W4200418084 hasConcept C126322002 @default.
- W4200418084 hasConcept C131872663 @default.
- W4200418084 hasConcept C141071460 @default.
- W4200418084 hasConcept C2776622691 @default.
- W4200418084 hasConcept C2777910003 @default.
- W4200418084 hasConcept C2778376644 @default.
- W4200418084 hasConcept C2779234561 @default.
- W4200418084 hasConcept C2779508502 @default.
- W4200418084 hasConcept C2910530332 @default.
- W4200418084 hasConcept C46973012 @default.
- W4200418084 hasConcept C54355233 @default.
- W4200418084 hasConcept C71924100 @default.
- W4200418084 hasConcept C72563966 @default.
- W4200418084 hasConcept C86803240 @default.
- W4200418084 hasConceptScore W4200418084C126322002 @default.
- W4200418084 hasConceptScore W4200418084C131872663 @default.
- W4200418084 hasConceptScore W4200418084C141071460 @default.
- W4200418084 hasConceptScore W4200418084C2776622691 @default.
- W4200418084 hasConceptScore W4200418084C2777910003 @default.
- W4200418084 hasConceptScore W4200418084C2778376644 @default.
- W4200418084 hasConceptScore W4200418084C2779234561 @default.
- W4200418084 hasConceptScore W4200418084C2779508502 @default.
- W4200418084 hasConceptScore W4200418084C2910530332 @default.
- W4200418084 hasConceptScore W4200418084C46973012 @default.
- W4200418084 hasConceptScore W4200418084C54355233 @default.
- W4200418084 hasConceptScore W4200418084C71924100 @default.
- W4200418084 hasConceptScore W4200418084C72563966 @default.
- W4200418084 hasConceptScore W4200418084C86803240 @default.
- W4200418084 hasIssue "1" @default.
- W4200418084 hasLocation W42004180841 @default.
- W4200418084 hasOpenAccess W4200418084 @default.
- W4200418084 hasPrimaryLocation W42004180841 @default.
- W4200418084 hasRelatedWork W1509138818 @default.
- W4200418084 hasRelatedWork W1977069374 @default.
- W4200418084 hasRelatedWork W2095565195 @default.
- W4200418084 hasRelatedWork W2107556987 @default.
- W4200418084 hasRelatedWork W2132973893 @default.
- W4200418084 hasRelatedWork W2419239561 @default.
- W4200418084 hasRelatedWork W2597746756 @default.
- W4200418084 hasRelatedWork W2761374007 @default.
- W4200418084 hasRelatedWork W2997362181 @default.
- W4200418084 hasRelatedWork W4362731385 @default.
- W4200418084 hasVolume "226" @default.
- W4200418084 isParatext "false" @default.
- W4200418084 isRetracted "false" @default.
- W4200418084 workType "article" @default.