Cited by 115Thyroid Disorders and TreatmentsHealth Systems, Economic Evaluations, Quality of LifeThyroid and Parathyroid Surgery

The cost-effectiveness of universal screening in pregnancy for subclinical hypothyroidism

Thung, Stephen F., Funai, Edmund F., Grobman, William A.·2009·American Journal of Obstetrics and Gynecology

Abstract

Objective The purpose of this study was to determine whether routine screening for subclinical hypothyroidism during pregnancy would be cost-effective.Study design We developed a decision analysis model to compare the cost-effectiveness of 2 screening strategies during pregnancy for subclinical hypothyroidism: (1) no routine screening of serum thyroid-stimulating hormone (TSH) levels (standard) and (2) routine screening of TSH levels. In the latter, women with subclinical hypothyroidism received thyroid hormone replacement. We assumed that thyroid hormone replacement could reduce the incidence of an offspring IQ < 85 for pregnancies with subclinical hypothyroidism. The main outcome measure was marginal cost per quality-adjusted life year (QALY) gained.Results Our model predicts that universal screening is the dominant strategy. For every 100,000 pregnant women who were screened, $8,356,383 are saved, and 589.3 QALYs are gained. When subclinical hypothyroidism prevalence is reduced to 0.25%, screening remains cost-effective at $21,664/QALY gained.Conclusion Screening for subclinical hypothyroidism in pregnancy will be a cost-effective strategy under a wide range of circumstances.

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Crossref · 10.1016/j.ajog.2008.10.035

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  • Prevention is now a leading research priority in two recent US and European mental health initiatives.

    “two recent initiatives in the US 98 and Europe 99 have included prevention among the top priorities for mental health research.”

    From Preventive strategies for mental health (2018) · cites this paper as [98]

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Authors
Thung, S. F., Funai, E. F., & Grobman, W. A.
Affiliations
  • Yale University (US)
  • Northwestern University (US)
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2009-03
Volume
200
Issue
3
Pages
267.e1-267.e7
ISSN
0002-9378 (ISSN-L)
OpenAlex
W2006626665
Cited by
115
References
39
Citations by year
2025: 3 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 7 · 2018: 5 · 2017: 10 · 2016: 4 · 2015: 7 · 2014: 9 · 2013: 15 · 2012: 18
FWCI
5.08
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
subclinical hypothyroidism, pregnancy, universal screening, cost-effectiveness, thyroid-stimulating hormone, thyroid hormone replacement, quality-adjusted life years, decision-analytic model
MeSH terms
Cost-Benefit Analysis, Decision Trees, Female, Humans, Hypothyroidism, Infant, Newborn, Mass Screening, Pregnancy, Pregnancy Complications, Thyrotropin, Incidence, Prevalence, Quality-Adjusted Life Years

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