{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T08:50:13Z","timestamp":1791881413611,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the cost\u2010effectiveness of the Fetal Medicine Foundation (FMF) strategy, compared with the National Institute for Health and Care Excellence (NICE) strategy, for first\u2010trimester screening for preterm preeclampsia (PE) in the United Kingdom (UK).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cost\u2010effectiveness analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>UK National Health Service and personal social services perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>A total of 10\u2009000 simulated patients with singleton pregnancies at 11\u201313\u2009weeks' gestation, across a lifetime time horizon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A decision\u2010tree model was developed to perform a cost\u2010effectiveness analysis. In the base\u2010case analysis, NICE\u2010recommended screening was compared with FMF screening, using maternal factors, mean arterial pressure (MAP), uterine artery pulsatility index (UtA\u2010PI) and placental growth factor (PlGF). The model assumed that patients identified as high\u2010risk for PE were prescribed 150\u2009mg aspirin daily until 36\u2009weeks' gestation. Scenario analyses varied PE incidence, aspirin adherence and biomarker combinations of FMF strategy components.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure<\/jats:title>\n                    <jats:p>Incremental cost\u2010effectiveness ratios (ICERs) were calculated using incremental costs and quality\u2010adjusted life years (QALYs). Dominant ICERs demonstrated lower costs and higher QALYs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with NICE\u2010recommended screening, the FMF strategy demonstrated a cost\u2010saving of \u00a33191 and QALY gain of 0.92 per 10\u2009000 patients (dominant ICER), with a cost\u2010saving of \u00a3199 per preterm PE case avoided. In scenario analyses, the FMF strategy was cost\u2010effective across 3%, 5% and 7% PE incidence, and 75% and 100% aspirin adherence. The base\u2010case FMF strategy (maternal factors\u2009+\u2009MAP\u2009+\u2009UtA\u2010PI\u2009+\u2009PlGF) was the most clinically effective option.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The FMF strategy was more cost\u2010effective versus the NICE strategy for first\u2010trimester preterm PE screening in the UK.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70294","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:18:30Z","timestamp":1782919110000},"page":"2178-2187","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["First Trimester Screening for Preterm Preeclampsia in the United Kingdom: A Cost\u2010Effectiveness Analysis"],"prefix":"10.1111","volume":"133","author":[{"given":"Mohammad A.","family":"Ani","sequence":"first","affiliation":[{"name":"Roche Diagnostics UK and Ireland  Burgess Hill UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3944-4130","authenticated-orcid":false,"given":"Liona C.","family":"Poon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Chinese University of Hong Kong  Shatin Hong Kong Special Administrative Region of China"},{"name":"Harris Birthright Research Centre for Fetal Medicine, King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1355-610X","authenticated-orcid":false,"given":"Laura A.","family":"Magee","sequence":"additional","affiliation":[{"name":"Department of Women and Children's Health School of Life Course and Population Sciences, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Joy","family":"Allen","sequence":"additional","affiliation":[{"name":"Roche Diagnostics UK and Ireland  Burgess Hill UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kypros H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine, King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2109523"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61351-7"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.08.045"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"key":"e_1_2_13_6_1","volume-title":"Recommendations | Hypertension in Pregnancy: Diagnosis and Management | Guidance | NICE","author":"National Institute for Health and Care Excellence","year":"2019"},{"issue":"1","key":"e_1_2_13_7_1","article-title":"Competing Risks Model in Screening for Preeclampsia by Maternal Factors and Biomarkers at 11\u201013\u2009Weeks Gestation","volume":"214","author":"O'Gorman N.","year":"2016","journal-title":"American Journal of Obstetrics and Gynecology"},{"key":"e_1_2_13_8_1","unstructured":"The Fetal Medicine Foundation \u201cRisk Assessment for Pre\u2010Eclampsia \u201d2025 https:\/\/fetalmedicine.org\/research\/assess\/preeclampsia\/first\u2010trimeste."},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12802"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19039"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.04.032"},{"key":"e_1_2_13_12_1","unstructured":"P.vonDadelszen K.Kavanagh andP.Murray \u201cpanPIERS (Pre\u2010Eclampsia Integrated Estimate of Risk Score): Artificial Intelligence\u2010Informed Time\u2010of\u2010Disease Risk Assessment for Women With Pre\u2010Eclampsia \u201d2021 https:\/\/fundingawards.nihr.ac.uk\/award\/AI_AWARD02166."},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19076"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2021.06.012"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0270490"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17598"},{"key":"e_1_2_13_17_1","unstructured":"National Institute for Health and Care Excellence \u201cNICE Technology Appraisal and Highly Specialised Technologies Guidance: The Manual \u201d2025 https:\/\/www.nice.org.uk\/process\/pmg36\/chapter\/economic\u2010evaluation\u20102#measuring\u2010and\u2010valuing\u2010health\u2010effects\u2010in\u2010cost\u2010utility\u2010analyses."},{"key":"e_1_2_13_18_1","unstructured":"National Institute for Health and Care Excellence \u201cPLGF\u2010Based Testing to Help Diagnose Suspected Preterm Pre\u2010Eclampsia | Guidance | NICE \u201d2022 https:\/\/www.nice.org.uk\/guidance\/htg630."},{"key":"e_1_2_13_19_1","unstructured":"National Institute for Health and Care Excellence \u201cPLGF\u2010based testing to help diagnose suspected preterm pre\u2010eclampsia | Guidance | NICE | Committee papers \u201d2022 https:\/\/www.nice.org.uk\/guidance\/htg630\/documents\/committee\u2010papers."},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60279-6"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69380-X"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19019"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S283239"},{"key":"e_1_2_13_24_1","unstructured":"World Health Organization \u201cPre\u2010Eclampsia \u201d2025 https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/pre\u2010eclampsia."},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.29255"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.561"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.08.110"},{"key":"e_1_2_13_28_1","unstructured":"National Institute for Health and Care Excellence \u201cChanges to NICE's Cost\u2010Effectiveness Thresholds Confirmed \u201d2025 https:\/\/www.nice.org.uk\/news\/articles\/changes\u2010to\u2010nice\u2010s\u2010cost\u2010effectiveness\u2010thresholds\u2010confirmed."},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20075418"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26106"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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