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第一个三个月的详细异常超声波查的临床和成本效益:混合方法研究研究
Jehan N Karim1, Helen Campbell1, Pranav Pandya2
1University of Oxford, Oxford, UK.
Health technology assessment (Winchester, England)
|June 2, 2025
概括
第一个三个月的胎儿异常超声波查是非常有效的,检测超过90%的主要条件与低错误阳性率. 这种早期查在临床上是有效的,具有成本效益,并且受到家长的青.
科学领域:
- 产科和妇科 产科和妇科
- 医疗成像医学成像
- 公共卫生 公共卫生
背景情况:
- 目前英国的指导方针建议在妊娠18-20周进行胎儿解剖查.
- 有证据表明,早期检测胎儿异常是可能的,在头三个月.
研究的目的:
- 评估详细的第一季度 (11-14周) 2D超声波用于胎儿异常检测的临床和成本效益.
- 为了评估这种查方法,除了标准的产前护理.
主要方法:
- 对诊断准确性的系统审查和元分析.
- 全国范围内对NHS信托进行调查,对先天性异常登记处进行分析.
- 共识程序,家长意见调查和概率性成本效益建模.
主要成果:
- 第一个三个月的超声波检测了八个主要异常中的93.3%,具有高特异性 (99.99%) 和积极的预测值 (96.5%).
- 对主要心脏异常的检测率为55.8%.
- 早期查与医疗保健成本增加有关 (每名妇女11英),但成本效益非常高 (ICER £5270),在每QALY20,000英的成本效益率超过95%的可能性. 父母的接受度很高 (>90%).
结论:
- 胎儿异常的标准化第一季度超声波查在临床上是有效的,主要疾病的检测率高于90%,错误阳性率低.
- 实施具有较低的决策不确定性,并代表了成本效益高的资源使用.
- 这种查方法对父母来说是可以接受的,并且值得纳入英国胎儿异常查计划.
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