Cost-effectiveness of the New Zealand diabetes in pregnancy guideline screening recommendations

Authors

Catherine Coop
Richard Edlin
Julie Brown
Cindy Farquhar

Year of Publication

2015

Source

BMJ Open, 5, e006996

Publication Type

Journal article (peer reviewed)

Publication Status

Completed

Abstract

The authors use a decision analytic model to compare the cost-effectiveness of 2 possible screening strategies for gestational diabetes mellitus (GDM): 2-step screening (glycated haemoglobin (HbA1c) test at first booking and a 2 h 75 g oral glucose tolerance test (OGTT) as a single test at 24–28 weeks) with 3-step screening (HbA1c test at first booking and a 1 h glucose challenge test (GCT) followed by a 2 h 75 g OGTT when indicated from 24–28 weeks) using a 9-month time horizon. The authors used a hypothetical cohort of 62,000 pregnant women in New Zealand. Probabilities, costs and benefits were derived from the literature, and supplementary data was obtained from National Women's Annual Clinical Reports. The authors conclude from their analysis that adopting a 2-step strategy would moderately increase the number of GDM cases detected at the same time as moderately increasing the number of women with false negatives at a significant cost to the health system. They go on to say that further evidence on the benefits of the 2 different approaches would be welcome.

How to Access

This is an open access article and can be read in free full text at: http://dx.doi.org/10.1136/bmjopen-2014-006996