{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,2]],"date-time":"2024-06-02T14:50:08Z","timestamp":1717339808492},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2010,12,31]],"date-time":"2010-12-31T00:00:00Z","timestamp":1293753600000},"content-version":"vor","delay-in-days":395,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Objective<\/jats:italic>. To investigate the potential cost\u2010effectiveness of alternative \u2018test\u2010and\u2010treat\u2019 strategies in the prevention of spontaneous pre\u2010term birth before 34 and 37 weeks' gestation.<jats:italic>Design<\/jats:italic>. Model\u2010based economic evaluation.<jats:italic>Setting.<\/jats:italic>Clinics, general practices, health centers or any setting delivering antenatal care.<jats:italic>Population.<\/jats:italic>Asymptomatic women in early pregnancy and symptomatic women with threatened pre\u2010term labor in later pregnancy.<jats:italic>Methods<\/jats:italic>. Data from systematic reviews of effectiveness and accuracy were combined into strategies and analyzed using a decision\u2010tree model. Full deterministic and probabilistic sensitivity analyses were carried out.<jats:italic>Main outcome measures.<\/jats:italic>Spontaneous pre\u2010term labor avoided for asymptomatic women and spontaneous pre\u2010term birth avoided for symptomatic women.<jats:italic>Results<\/jats:italic>. The systematic reviews identified evidence on the accuracy of 22 types of tests and on the effectiveness of 40 possible interventions. Cost data were based on secondary evidence, supplemented with primary data from local sources. Testing prior to intervention was not shown to be the most cost\u2010effective strategy in the main analyses for 34 and 37 weeks. Prophylactic fish oil in asymptomatic women, without prior testing, was highlighted as potentially cost\u2010effective in preventing threatened pre\u2010term labor before 34 weeks. In symptomatic women with a viable pregnancy, indomethacin without prior testing was a potentially cost\u2010effective strategy to prevent pre\u2010term birth occurring before 37 weeks.<jats:italic>Conclusion.<\/jats:italic>An effective, affordable and safe intervention applied to all mothers without prior testing is likely to be the most cost\u2010effective strategy in the prevention of spontaneous pre\u2010term labor and birth. The results reported in this paper are important for prioritizing future research, world\u2010wide.<\/jats:p>","DOI":"10.3109\/00016340903410873","type":"journal-article","created":{"date-parts":[[2009,11,30]],"date-time":"2009-11-30T12:44:11Z","timestamp":1259585051000},"page":"1319-1330","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["An economic evaluation of alternative test\u2010intervention strategies to prevent spontaneous pre\u2010term birth in singleton pregnancies"],"prefix":"10.1111","volume":"88","author":[{"given":"ANGELOS","family":"TSOURAPAS","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"TRACY E.","family":"ROBERTS","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PELHAM 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