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The cost-effectiveness of universal screening in pregnancy for subclinical hypothyroidism
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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Edlow, A. G., & Norwitz, E. R. (2013) · Elsevier eBooks · doi:10.1016/b978-1-4557-2758-2.00028-7 · Cited by 2
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A therapeutic play program for children undergoing day surgery
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Higher TSH levels in the first trimester of pregnancy are related to lower birth weight
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Metadata
- 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
- Licence
- 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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