A Lesson From Behavioral Economics for Reducing Obstetric Interventions—Placing More Weight on Perceived Gains vs Perceived Losses

Triunfo, Stefania

doi:10.1001/jamanetworkopen.2022.2181

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…5,13,15,16,19 False-positive screening results can lead to more obstetric interventions, parental anxiety and the overuse of health system resources. 21,22 One hypothesis for the poor performance of FGR screening is unstandardised protocols for assessing and reporting screening results. This hypothesis is supported by surveys of maternity unit policies that document high variability in FGR screening practices between centres, [23][24][25] as well as population-based studies that report incomplete information on biometric measures in medical notes and ultrasound reports.…”

Section: Introductionmentioning

confidence: 99%

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Serial plotting of symphysis–fundal height and estimated fetal weight to improve the antenatal detection of infants small for gestational age: A cluster randomised trial

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Monier

Vilotitch

et al. 2023

BJOG

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Objective To assess whether standardised longitudinal reporting of growth monitoring information improves antenatal detection of infants who are small for gestational age (SGA), compared with usual care. Design Cluster‐randomised controlled trial. Setting Sixteen French level‐3 units in 2018–2019. Population Singleton pregnancies. Methods The intervention consisted of the serial plotting of symphysis–fundal height (SFH) and estimated fetal weight (EFW) measurements on customised growth charts using a software program, compared with standard antenatal care. We estimated relative risks (RR) adjusted for known risk factors for fetal growth restriction (FGR). Main Outcome Measures The primary outcome was antenatal detection of FGR among SGA births (with birthweights below the tenth centile of French customised curves), defined as the mention of suspected FGR in medical records and either referral ultrasounds for growth monitoring or indicated delivery for FGR. Secondary outcomes were false‐positive rates, mode of delivery, perinatal morbidity and mortality, and number of antenatal visits and ultrasounds. Results In total, seven intervention clusters (n = 4349) and eight control clusters (n = 4943) were analysed, after the exclusion of one intervention centre for a major deviation in protocol. SGA births represented 613 (14.1%) and 626 (12.7%) of all births, respectively. The rates of antenatal detection of FGR among SGA births were 40.0% in the intervention arm versus 37.1% in the control arm (crude RR 1.08, 95% CI 0.87–1.34; adj RR 1.09, 95% CI 0.88–1.35). No benefits of the intervention were detected in the analyses of secondary outcomes. Conclusions Serial plotting of SFH and EFW measurements on customised growth charts did not improve the antenatal detection of FGR among SGA births.

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Section: Introductionmentioning

confidence: 99%

“…In addition to low sensitivity, false‐positive rates (babies who are not SGA but are suspected of having FGR) range from 1% to 5%, often representing half of all detected cases 5,13,15,16,19 . False‐positive screening results can lead to more obstetric interventions, parental anxiety and the overuse of health system resources 21,22 …”

Section: Introductionmentioning

confidence: 99%

Serial plotting of symphysis–fundal height and estimated fetal weight to improve the antenatal detection of infants small for gestational age: A cluster randomised trial

Ego

Monier

Vilotitch

et al. 2023

BJOG

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Behavioral Economics in the Delivery of Women’s Health: Next Horizons for Improvements in Practice

Yeh

2023

CWHR

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A Lesson From Behavioral Economics for Reducing Obstetric Interventions—Placing More Weight on Perceived Gains vs Perceived Losses

Abstract: Medical decisions can be extremely complex, relying not only on the physician's knowledge, experience, and judgment, but also on patient medical history, views, and wishes. In obstetrics,

Cited by 2 publications

References 8 publications

Serial plotting of symphysis–fundal height and estimated fetal weight to improve the antenatal detection of infants small for gestational age: A cluster randomised trial

Serial plotting of symphysis–fundal height and estimated fetal weight to improve the antenatal detection of infants small for gestational age: A cluster randomised trial

Behavioral Economics in the Delivery of Women’s Health: Next Horizons for Improvements in Practice

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