Maternal serologic screening to prevent congenital toxoplasmosis: a decision-analytic economic model.
To determine a cost-minimizing option for congenital toxoplasmosis in the United States.A decision-analytic and cost-minimization model was constructed to compare monthly maternal serological screening, prenatal treatment, and post-natal follow-up and treatment according to the current French (Paris...
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ftdoajarticles:oai:doaj.org/article:2d0610003e5b4f68b22c2b26ca739a02 2023-05-15T15:11:52+02:00 Maternal serologic screening to prevent congenital toxoplasmosis: a decision-analytic economic model. Eileen Stillwaggon Christopher S Carrier Mari Sautter Rima McLeod 2011-09-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0001333 https://doaj.org/article/2d0610003e5b4f68b22c2b26ca739a02 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3181241?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001333 https://doaj.org/article/2d0610003e5b4f68b22c2b26ca739a02 PLoS Neglected Tropical Diseases, Vol 5, Iss 9, p e1333 (2011) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2011 ftdoajarticles https://doi.org/10.1371/journal.pntd.0001333 2022-12-31T13:04:09Z To determine a cost-minimizing option for congenital toxoplasmosis in the United States.A decision-analytic and cost-minimization model was constructed to compare monthly maternal serological screening, prenatal treatment, and post-natal follow-up and treatment according to the current French (Paris) protocol, versus no systematic screening or perinatal treatment. Costs are based on published estimates of lifetime societal costs of developmental disabilities and current diagnostic and treatment costs. Probabilities are based on published results and clinical practice in the United States and France. One- and two-way sensitivity analyses are used to evaluate robustness of results. Universal monthly maternal screening for congenital toxoplasmosis with follow-up and treatment, following the French protocol, is found to be cost-saving, with savings of $620 per child screened. Results are robust to changes in test costs, value of statistical life, seroprevalence in women of childbearing age, fetal loss due to amniocentesis, and to bivariate analysis of test costs and incidence of primary T. gondii infection in pregnancy. Given the parameters in this model and a maternal screening test cost of $12, screening is cost-saving for rates of congenital infection above 1 per 10,000 live births. If universal testing generates economies of scale in diagnostic tools-lowering test costs to about $2 per test-universal screening is cost-saving at rates of congenital infection well below the lowest reported rates in the United States of 1 per 10,000 live births.Universal screening according to the French protocol is cost saving for the US population within broad parameters for costs and probabilities. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 5 9 e1333 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Eileen Stillwaggon Christopher S Carrier Mari Sautter Rima McLeod Maternal serologic screening to prevent congenital toxoplasmosis: a decision-analytic economic model. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
To determine a cost-minimizing option for congenital toxoplasmosis in the United States.A decision-analytic and cost-minimization model was constructed to compare monthly maternal serological screening, prenatal treatment, and post-natal follow-up and treatment according to the current French (Paris) protocol, versus no systematic screening or perinatal treatment. Costs are based on published estimates of lifetime societal costs of developmental disabilities and current diagnostic and treatment costs. Probabilities are based on published results and clinical practice in the United States and France. One- and two-way sensitivity analyses are used to evaluate robustness of results. Universal monthly maternal screening for congenital toxoplasmosis with follow-up and treatment, following the French protocol, is found to be cost-saving, with savings of $620 per child screened. Results are robust to changes in test costs, value of statistical life, seroprevalence in women of childbearing age, fetal loss due to amniocentesis, and to bivariate analysis of test costs and incidence of primary T. gondii infection in pregnancy. Given the parameters in this model and a maternal screening test cost of $12, screening is cost-saving for rates of congenital infection above 1 per 10,000 live births. If universal testing generates economies of scale in diagnostic tools-lowering test costs to about $2 per test-universal screening is cost-saving at rates of congenital infection well below the lowest reported rates in the United States of 1 per 10,000 live births.Universal screening according to the French protocol is cost saving for the US population within broad parameters for costs and probabilities. |
format |
Article in Journal/Newspaper |
author |
Eileen Stillwaggon Christopher S Carrier Mari Sautter Rima McLeod |
author_facet |
Eileen Stillwaggon Christopher S Carrier Mari Sautter Rima McLeod |
author_sort |
Eileen Stillwaggon |
title |
Maternal serologic screening to prevent congenital toxoplasmosis: a decision-analytic economic model. |
title_short |
Maternal serologic screening to prevent congenital toxoplasmosis: a decision-analytic economic model. |
title_full |
Maternal serologic screening to prevent congenital toxoplasmosis: a decision-analytic economic model. |
title_fullStr |
Maternal serologic screening to prevent congenital toxoplasmosis: a decision-analytic economic model. |
title_full_unstemmed |
Maternal serologic screening to prevent congenital toxoplasmosis: a decision-analytic economic model. |
title_sort |
maternal serologic screening to prevent congenital toxoplasmosis: a decision-analytic economic model. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2011 |
url |
https://doi.org/10.1371/journal.pntd.0001333 https://doaj.org/article/2d0610003e5b4f68b22c2b26ca739a02 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 5, Iss 9, p e1333 (2011) |
op_relation |
http://europepmc.org/articles/PMC3181241?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001333 https://doaj.org/article/2d0610003e5b4f68b22c2b26ca739a02 |
op_doi |
https://doi.org/10.1371/journal.pntd.0001333 |
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PLoS Neglected Tropical Diseases |
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5 |
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9 |
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e1333 |
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