Waitzman N J, Romano P S
Department of Economics, University of Utah, Salt Lake City 84112-9300, USA.
Ann N Y Acad Sci. 1998 Jun 18;847:141-53. doi: 10.1111/j.1749-6632.1998.tb08935.x.
No comprehensive benefit-to-cost analysis has been performed to date on a policy of routine ultrasound screening for fetal anomalies in the United States. We performed a preliminary benefit-to-cost analysis drawing upon our previous research on the cost or birth defects in the United States and upon the literature regarding (1) the sensitivity of ultrasound in detecting congenital anomalies, (2) the rate at which pregnancies are terminated upon detection of fetal anomalies, (3) the number of ultrasounds performed per pregnancy under a routine screening policy, and (4) the average cost of an ultrasound. We assumed a 100% subsequent replacement rate of terminated pregnancies with a normal child, an assumption most favorable to routine screening. The benefit-to-cost ratio ranged from .33 to 3, suggesting that a routine screening policy for fetal anomalies is of uncertain net societal benefit. Routine screening may be justified, however, based on standards that elude the methods for establishing societal benefits adopted in this analysis.
迄今为止，美国尚未对胎儿异常的常规超声筛查政策进行全面的成本效益分析。我们利用之前关于美国出生缺陷成本的研究以及以下方面的文献进行了初步成本效益分析：（1）超声检测先天性异常的敏感性；（2）检测到胎儿异常后终止妊娠的比例；（3）常规筛查政策下每次妊娠进行超声检查的次数；（4）超声检查的平均成本。我们假设终止妊娠后正常孩子的后续替代率为100%，这是对常规筛查最有利的假设。成本效益比在0.33至3之间，这表明胎儿异常的常规筛查政策的社会净效益不确定。然而，根据本分析中采用的确定社会效益的方法无法涵盖的标准，常规筛查可能是合理的。
