{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T04:14:53Z","timestamp":1778645693236,"version":"3.51.4"},"reference-count":34,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"am","delay-in-days":354,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U10 HD27049"],"award-info":[{"award-number":["U10 HD27049"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U10 HD39005"],"award-info":[{"award-number":["U10 HD39005"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U10HD055925"],"award-info":[{"award-number":["U10HD055925"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U10HD077680"],"award-info":[{"award-number":["U10HD077680"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U10 HD077844"],"award-info":[{"award-number":["U10 HD077844"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["ajog.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Obstetrics and Gynecology"],"published-print":{"date-parts":[[2024,9]]},"DOI":"10.1016\/j.ajog.2024.03.035","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T04:11:03Z","timestamp":1711512663000},"page":"328.e1-328.e11","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cost-effectiveness analysis of expectant vs active management for treatment of persistent pregnancies of unknown location"],"prefix":"10.1016","volume":"231","author":[{"given":"Jessica R.","family":"Walter","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kurt T.","family":"Barnhart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathanael C.","family":"Koelper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanette F.","family":"Santoro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heping","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracey R.","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi S.","family":"Harvie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajog.2024.03.035_bib1","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/j.fertnstert.2010.09.006","article-title":"Pregnancy of unknown location: a consensus statement of nomenclature, definitions, and outcome","volume":"95","author":"Barnhart","year":"2011","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajog.2024.03.035_bib2","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1056\/NEJMcp0810384","article-title":"Clinical practice. Ectopic pregnancy","volume":"361","author":"Barnhart","year":"2009","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ajog.2024.03.035_bib3","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1001\/jama.2021.10767","article-title":"Effect of an active vs expectant management strategy on successful resolution of pregnancy among patients with a persisting pregnancy of unknown location: the ACT or NOT randomized clinical trial","volume":"326","author":"Barnhart","year":"2021","journal-title":"JAMA"},{"key":"10.1016\/j.ajog.2024.03.035_bib4","first-page":"158","article-title":"Expectant management of early pregnancies of unknown location: a prospective evaluation of methods to predict spontaneous resolution of pregnancy","volume":"108","author":"Banerjee","year":"2001","journal-title":"BJOG"},{"key":"10.1016\/j.ajog.2024.03.035_bib5","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1093\/humrep\/deh746","article-title":"A\u00a0prospective evaluation of a single-visit strategy to manage pregnancies of unknown location","volume":"20","author":"Condous","year":"2005","journal-title":"Hum Reprod"},{"key":"10.1016\/j.ajog.2024.03.035_bib6","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1016\/j.fertnstert.2012.09.032","article-title":"Is there a need to definitively diagnose the location of a pregnancy of unknown location? The case for \u201dno\u201d","volume":"98","author":"Reid","year":"2012","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajog.2024.03.035_bib7","doi-asserted-by":"crossref","first-page":"130.e1","DOI":"10.1016\/j.ajog.2010.11.021","article-title":"Utility of dilation and curettage in the diagnosis of pregnancy of unknown location","volume":"204","author":"Shaunik","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajog.2024.03.035_bib8","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1016\/j.fertnstert.2012.09.033","article-title":"Do you need to definitively diagnose the location of a pregnancy of unknown location? The case for \u201dyes\u201d","volume":"98","author":"Rubal","year":"2012","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajog.2024.03.035_bib9","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.cct.2018.09.009","article-title":"Optimal treatment for women with a persisting pregnancy of unknown location, a randomized controlled trial: the ACT-or-NOT trial","volume":"73","author":"Barnhart","year":"2018","journal-title":"Contemp Clin Trials"},{"key":"10.1016\/j.ajog.2024.03.035_bib10","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.fertnstert.2006.06.054","article-title":"Use of \u201d2-dose\u201d regimen of methotrexate to treat ectopic pregnancy","volume":"87","author":"Barnhart","year":"2007","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajog.2024.03.035_bib11","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1001\/jama.2016.12195","article-title":"Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health and medicine","volume":"316","author":"Sanders","year":"2016","journal-title":"JAMA"},{"key":"10.1016\/j.ajog.2024.03.035_bib12","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1001\/jama.2019.1265","article-title":"Overview of cost-effectiveness analysis","volume":"321","author":"Sanders","year":"2019","journal-title":"JAMA"},{"key":"10.1016\/j.ajog.2024.03.035_bib13","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jval.2013.02.010","article-title":"Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement","volume":"16","author":"Husereau","year":"2013","journal-title":"Value Health"},{"key":"10.1016\/j.ajog.2024.03.035_bib14","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.1594","article-title":"Cost-effectiveness of mifepristone pretreatment for the medical management of nonviable early pregnancy: secondary analysis of a randomized clinical trial","volume":"3","author":"Nagendra","year":"2020","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.ajog.2024.03.035_bib15","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.fertnstert.2011.11.044","article-title":"A\u00a0cost-effectiveness analysis of surgical versus medical management of early pregnancy loss","volume":"97","author":"Rausch","year":"2012","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajog.2024.03.035_bib16","doi-asserted-by":"crossref","first-page":"490","DOI":"10.2165\/00019053-199507060-00004","article-title":"Multi-attribute health status classification systems. Health utilities index","volume":"7","author":"Feeny","year":"1995","journal-title":"Pharmacoeconomics"},{"key":"10.1016\/j.ajog.2024.03.035_bib17","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/0168-8510(96)00822-6","article-title":"EuroQol: the current state of play","volume":"37","author":"Brooks","year":"1996","journal-title":"Health Policy"},{"key":"10.1016\/j.ajog.2024.03.035_bib18","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1097\/01.MLR.0000044901.57067.19","article-title":"Measuring population health: a comparison of three generic health status measures","volume":"41","author":"Macran","year":"2003","journal-title":"Med Care"},{"key":"10.1016\/j.ajog.2024.03.035_bib19","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S0015-0282(98)00212-X","article-title":"Systemic methotrexate therapy versus laparoscopic salpingostomy in patients with tubal pregnancy. Part I. Impact on patients\u2019 health-related quality of life","volume":"70","author":"Nieuwkerk","year":"1998","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajog.2024.03.035_bib20","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/S0015-0282(98)00213-1","article-title":"Systemic methotrexate therapy versus laparoscopic salpingostomy in tubal pregnancy. Part II. Patient preferences for systemic methotrexate","volume":"70","author":"Nieuwkerk","year":"1998","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajog.2024.03.035_bib21","series-title":"Economic evaluation in clinical trials","author":"Glick","year":"2013"},{"key":"10.1016\/j.ajog.2024.03.035_bib22","doi-asserted-by":"crossref","first-page":"3219","DOI":"10.1002\/1097-0258(20001215)19:23<3219::AID-SIM623>3.0.CO;2-P","article-title":"Analysis of cost data in randomized trials: an application of the non-parametric bootstrap","volume":"19","author":"Barber","year":"2000","journal-title":"Stat Med"},{"key":"10.1016\/j.ajog.2024.03.035_bib23","series-title":"An introduction to the bootstrap","author":"Efron","year":"1994"},{"key":"10.1016\/j.ajog.2024.03.035_bib24","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jval.2015.02.001","article-title":"Cost-effectiveness analysis alongside clinical trials II-An ISPOR Good Research Practices Task Force report","volume":"18","author":"Ramsey","year":"2015","journal-title":"Value Health"},{"key":"10.1016\/j.ajog.2024.03.035_bib25","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1192\/bjp.187.2.106","article-title":"A\u00a0guide to cost-effectiveness acceptability curves","volume":"187","author":"Fenwick","year":"2005","journal-title":"Br J Psychiatry"},{"key":"10.1016\/j.ajog.2024.03.035_bib26","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1002\/hec.903","article-title":"Cost-effectiveness acceptability curves\u2014facts, fallacies and frequently asked questions","volume":"13","author":"Fenwick","year":"2004","journal-title":"Health Econ"},{"key":"10.1016\/j.ajog.2024.03.035_bib27","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1056\/NEJMp1405158","article-title":"Updating cost-effectiveness\u2014the curious resilience of the $50,000-per-QALY threshold","volume":"371","author":"Neumann","year":"2014","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ajog.2024.03.035_bib28","unstructured":"Kaiser Family Foundation. How much more than Medicare do private insurers pay? A review of the literature. Available at: https:\/\/www.kff.org\/medicare\/issue-brief\/how-much-more-than-medicare-do-private-insurers-pay-a-review-of-the-literature\/#:~:text=Based%20on%20the%20reviewed%20studies,inpatient%20hospital%20services%2C%20264%25%20of. Accessed December 1, 2020."},{"key":"10.1016\/j.ajog.2024.03.035_bib29","doi-asserted-by":"crossref","DOI":"10.1016\/j.fertnstert.2014.07.810","article-title":"A\u00a0cost-effective analysis of methotrexate, d&c, or observation as initial approach to pregnancy of unknown location","volume":"102","author":"Moravek","year":"2014","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajog.2024.03.035_bib30","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.fertnstert.2004.06.068","article-title":"Cost-effectiveness of presumptively medically treating women at risk for ectopic pregnancy compared with first performing a dilatation and curettage","volume":"83","author":"Ailawadi","year":"2005","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajog.2024.03.035_bib31","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12958-015-0025-0","article-title":"Ectopic pregnancy secondary to in\u00a0vitro fertilisation-embryo transfer: pathogenic mechanisms and management strategies","volume":"13","author":"Refaat","year":"2015","journal-title":"Reprod Biol Endocrinol"},{"key":"10.1016\/j.ajog.2024.03.035_bib32","doi-asserted-by":"crossref","first-page":"154","DOI":"10.4103\/0974-1208.101011","article-title":"Ectopic pregnancy after infertility treatment","volume":"5","author":"Patil","year":"2012","journal-title":"J\u00a0Hum Reprod Sci"},{"key":"10.1016\/j.ajog.2024.03.035_bib33","first-page":"246","article-title":"Patient attitudes and preferences for management of pregnancy of unknown location","volume":"3","author":"Wu","year":"2022","journal-title":"F\u00a0S Rep"},{"key":"10.1016\/j.ajog.2024.03.035_bib34","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1159\/000488760","article-title":"Trends in the management of nonviable pregnancies of\u00a0unknown location in the United States","volume":"83","author":"Parks","year":"2018","journal-title":"Gynecol Obstet Invest"}],"container-title":["American Journal of Obstetrics and Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S000293782400471X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S000293782400471X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T04:07:01Z","timestamp":1778645221000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S000293782400471X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":34,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["S000293782400471X"],"URL":"https:\/\/doi.org\/10.1016\/j.ajog.2024.03.035","relation":{},"ISSN":["0002-9378"],"issn-type":[{"value":"0002-9378","type":"print"}],"subject":[],"published":{"date-parts":[[2024,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Cost-effectiveness analysis of expectant vs active management for treatment of persistent pregnancies of unknown location","name":"articletitle","label":"Article Title"},{"value":"American Journal of Obstetrics and Gynecology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajog.2024.03.035","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2024 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}