{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:26:24Z","timestamp":1788269184454,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,3,30]],"date-time":"2018-03-30T00:00:00Z","timestamp":1522368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001826","name":"The Netherlands Organization for Health Research and Development","doi-asserted-by":"crossref","award":["80-82310-98-09056"],"award-info":[{"award-number":["80-82310-98-09056"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the cost\u2010effectiveness of combining cervical\u2010length (CL) measurement and fetal fibronectin (fFN) testing in women with symptoms of preterm labor between 24 and 34 weeks' gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a model\u2010based cost\u2010effectiveness analysis evaluating seven test\u2013treatment strategies based on CL measurement and\/or fFN testing in women with symptoms of preterm labor from a societal perspective, in which neonatal outcomes and costs were weighted. Estimates of disease prevalence, test accuracy and costs were based on two recently performed nationwide cohort studies in The Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Strategies using fFN testing and CL measurement separately to predict preterm delivery are associated with higher costs and incidence of adverse neonatal outcomes compared with strategies that combine both tests. Additional fFN testing when CL is 15\u201330 mm was considered cost effective, leading to a cost saving of \u20ac3919 per woman when compared with a treat\u2010all strategy, with a small deterioration in neonatal health outcomes, namely one additional perinatal death and 21 adverse outcomes per 10 000 women with signs of preterm labor (incremental cost\u2010effectiveness ratios \u20ac39 million and \u20ac1.9 million, respectively). Implementing this strategy in The Netherlands, a country with about 180 000 deliveries annually, could lead to an annual cost saving of between \u20ac2.4 million and \u20ac7.6 million, with only a small deterioration in neonatal health outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In women with symptoms of preterm labor at 24\u201334 weeks' gestation, performing additional fFN testing when CL is between 15 and 30 mm is a viable and cost\u2010saving strategy. Copyright \u00a9 2017 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.17481","type":"journal-article","created":{"date-parts":[[2017,3,31]],"date-time":"2017-03-31T08:11:02Z","timestamp":1490947862000},"page":"596-603","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Cost\u2010effectiveness of diagnostic testing strategies including cervical\u2010length measurement and fibronectin testing in women with symptoms of preterm labor"],"prefix":"10.1002","volume":"51","author":[{"given":"G.\u2010J.","family":"van Baaren","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Y.","family":"Vis","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry and Hematology University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. F.","family":"Wilms","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology M\u00e1xima Medical Center  Veldhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. A.","family":"Oudijk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kwee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. M.","family":"Porath","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology M\u00e1xima Medical Center  Veldhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. C. J.","family":"Scheepers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Hospital Maastricht  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. E. A.","family":"Spaanderman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Hospital Maastricht  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. W. M.","family":"Bloemenkamp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. C.","family":"Haak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. J.","family":"Bax","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M. J.","family":"Cornette","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Erasmus Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. J.","family":"Duvekot","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Erasmus Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. W. 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