Vatish M, Strunz-McKendry T, Hund M, Allegranza D, Wolf C, Smare C
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK.
Roche Diagnostics Ltd, Burgess Hill, UK.
Ultrasound Obstet Gynecol. 2016 Dec;48(6):765-771. doi: 10.1002/uog.15997. Epub 2016 Nov 8.
To assess the economic impact of introducing into clinical practice in the UK the soluble fms-like tyrosine kinase (sFlt-1) to placental growth factor (PlGF) ratio test for guiding the management of pre-eclampsia.
We used an economic model estimating the incremental value of information, from a UK National Health Service payer's perspective, generated by the sFlt-1/PlGF ratio test, compared with current diagnostic procedures, in guiding the management of women with suspected pre-eclampsia. The economic model estimated costs associated with the diagnosis and management of pre-eclampsia in pregnant women between 24 + 0 and 36 + 6 weeks' gestation, managed in either a 'test' scenario in which the sFlt-1/PlGF test is used in addition to current diagnostic procedures, or a 'no-test' scenario in which clinical decisions are based on current diagnostic procedures alone. Test characteristics and resource use were derived from PROGNOSIS, a non-interventional study in women presenting with clinical suspicion of pre-eclampsia. The main outcome measure from the economic model was the cost per patient per episode of care, from first suspicion of pre-eclampsia to birth.
Introduction of the sFlt-1/PlGF ratio test into clinical practice is expected to result in cost savings of £344 per patient compared with a no-test scenario. Savings are generated primarily through an improvement in diagnostic accuracy and subsequent reduction in unnecessary hospitalization.
Introducing the sFlt-1/PlGF ratio test into clinical practice in the UK was shown to be cost-saving by reducing unnecessary hospitalization of women at low risk of developing pre-eclampsia. In addition, the test ensures that those women at higher risk are identified and managed appropriately. © 2016 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
评估在英国临床实践中引入可溶性fms样酪氨酸激酶（sFlt-1）与胎盘生长因子（PlGF）比值检测以指导子痫前期管理的经济影响。
我们使用了一个经济模型，从英国国家医疗服务体系支付方的角度，评估与当前诊断程序相比，sFlt-1/PlGF比值检测在指导疑似子痫前期女性管理中所产生的信息增量价值。该经济模型估计了妊娠24 + 0至36 + 6周孕妇子痫前期诊断和管理的相关成本，管理方式分为“检测”方案（在当前诊断程序基础上使用sFlt-1/PlGF检测）和“无检测”方案（临床决策仅基于当前诊断程序）。检测特征和资源使用数据来自PROGNOSIS，这是一项针对临床疑似子痫前期女性的非干预性研究。经济模型的主要结局指标是从首次怀疑子痫前期到分娩期间每位患者每次护理的成本。
与无检测方案相比，将sFlt-1/PlGF比值检测引入临床实践预计每位患者可节省344英镑。节省主要源于诊断准确性的提高以及随后不必要住院的减少。
在英国临床实践中引入sFlt-1/PlGF比值检测可通过减少子痫前期低风险女性的不必要住院而节省成本。此外，该检测可确保识别出高风险女性并进行适当管理。© 2016作者。《妇产科超声》由John Wiley & Sons Ltd代表国际妇产科超声学会出版。
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