The effects of neonatal screening for sickle cell disorders on lifetime treatment costs and early deaths avoided: a modelling approach

Karnon, Jonathan; Zeuner, Dagmar; Ades, A E; Efimba, Wasse; Brown, Joshua R.; Yardumian, A

doi:10.1093/pubmed/22.4.500

Cited by 12 publications

(12 citation statements)

References 48 publications

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“…20 years). Similar lifetime extrapolation models have previously been developed in the areas of thalassaemia and sickle cell disease [40,41]. The resulting dataset will contain estimates of the short- and long-term costs and outcomes for all patients (mother and child), and will be analysed to estimate the expected costs and outcomes in the patient cohorts receiving the different levels of care.…”

Section: Methodsmentioning

confidence: 99%

A randomized controlled trial to assess the clinical and cost effectiveness of a nurse-led Antenatal Asthma Management Service in South Australia (AAMS study)

Grzeskowiak

Dekker

Rivers

et al. 2014

BMC Pregnancy Childbirth

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BackgroundPregnancy presents a unique situation for the management of asthma as it can alter the course of asthma severity and its treatment, which in turn can affect pregnancy outcomes. Despite awareness of the substantial adverse effects associated with asthma during pregnancy, little has been done to improve its management and reduce associated perinatal morbidity and mortality. The aim of this randomized controlled trial is to evaluate the clinical and cost effectiveness of an Antenatal Asthma Management Service.Methods/designDesign: Multicentre, randomized controlled trial.Inclusion criteria: Women with physician diagnosed asthma, which is not currently in remission, who are less than 20 weeks gestation with a singleton pregnancy and do not have a chronic medical condition.Trial entry and randomization: Eligible women with asthma, stratified by treatment site, disease severity and parity, will be randomized into either the ‘Standard Care Group’ or the ‘Intervention Group’.Study groups: Both groups will be followed prospectively throughout pregnancy. Women in the ‘Standard Care Group’ will receive routine obstetric care reflecting current clinical practice in Australian hospitals. Women in the ‘Intervention Group’ will receive additional care through the nurse-led Antenatal Asthma Management Service, based in the antenatal outpatient clinic. Women will receive asthma education with a full assessment of their asthma at 18, 24, 30 and 36 weeks gestation. Each antenatal visit will include a 60 min session where asthma management skills are assessed including: medication adherence and knowledge, inhaler device technique, recognition of asthma deterioration and possession of a written asthma action plan. Furthermore, subjects will receive education about asthma control and management skills including trigger avoidance and smoking cessation counseling when appropriate.Primary study outcome: Asthma exacerbations during pregnancy.Sample size: A sample size of 378 women will be sufficient to show an absolute reduction in asthma exacerbations during pregnancy of 20% (alpha 0.05 two-tailed, 90% power, 5% loss to follow-up).DiscussionThe integration of an asthma education program within the antenatal clinic setting has the significant potential to improve the participation of pregnant women in the self-management of their asthma, reduce asthma exacerbations and improve perinatal health outcomes.Trial registrationACTRN12613000244707

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Section: Methodsmentioning

confidence: 99%

A randomized controlled trial to assess the clinical and cost effectiveness of a nurse-led Antenatal Asthma Management Service in South Australia (AAMS study)

Grzeskowiak

Dekker

Rivers

et al. 2014

BMC Pregnancy Childbirth

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“…Die ersten Lebensmonate bieten sich für die Früherkennung an. Früherkennung kann Leben retten [13]. "Da bereits die Manifestation einer SCD lebensbedrohlich sein kann (Milzsequestrationskrise, Sepsis bei funktioneller Asplenie), ist ein Neugeborenenscreening für die SCD indiziert" [9].…”

Section: Diagnose Und Behandlung Von Scdunclassified

Sichelzellkrankheit unter Neugeborenen in Deutschland: Eine Studie an Routinedaten der AOK

Pattloch

2018

Gesundheitswesen

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Zusammenfassung Hintergrund Die Sichelzellkrankheit (SCD, ICD-10:D57) ist eine autosomal rezessiv vererbte Hämoglobinkrankheit mit globaler Public-Health-Relevanz. In Deutschland kommen pro Jahr 70–150 Kinder mit SCD zur Welt (1–2 je 10 000 Neugeborene). Die Früherkennung im asymptomatischen ersten Vierteljahr wäre leitliniengerecht und sekundärpräventiv bedeutsam. Ziel der Studie Das Ziel dieser Arbeit ist 1) die Ermittlung der Prävalenz von SCD in Routinedaten von AOK-versicherten Neugeborenen, 2) die Messung des Alters bei der Erstdiagnose D57, 3) die Zählung charakteristischer Krankenhausdiagnosen. Methode Analysiert wurden ambulante und stationäre Routinedaten von 204 AOK-versicherten Kindern. Dies sind alle, die 2009–2010 geboren sind, mindestens einen Tag im Geburtsjahr AOK-versichert waren und innerhalb von 6 Kalenderjahren jemals einen Code D57 erhielten. Die Anzahl Neugeborener in der AOK 2009–2010 (Nennerpopulation) ist bekannt. SCD-Fälle (Zähler) gelten als validiert, wenn D57 (außer D57.3) in mindestens 2 Quartalen (Q) codiert wurde. Es wird die Prävalenzproportion mit Bootstrap-Konfidenzintervall (CI) berechnet. Pro Fall wird quartalsgenau ausgelesen, wann D57 erstmals auftaucht. Der Standardized Incidence Ratio (SIR) wird berechnet für Krankenhausfälle vom Monat 13 bis Monat 61 im Vergleich zur Bevölkerung gleichen Geschlechts und Alters (1 bis unter 5 Jahre). Die Auswertung erfolgt mit SPSS 22 und Excel. Ergebnis Nach interner Validierung resultierten 78 Fälle von SCD. Die Prävalenz beträgt 1,96 (95% CI 1,53–2,41) pro 10 000 Neugeborene. Regionale Schwerpunkte zeigten sich in Berlin, Bremen, Hamburg (zusammengefasst) sowie in Nordrhein-Westfalen. Die Erstnennung von D57 erfolgte nur bei 15,4% der Fälle früh, d. h. in Q1–2. Der Median liegt in Q7. In 78 Fällen ereigneten sich 266 Krankenhausfälle mit einem SIR=6,8, d. h. die Hospitalisierungsrate ist 6,8fach höher als die der Bevölkerung. Unter den Entlassungsdiagnosen fanden sich gefürchtete Outcomes wie Pneumonie, Sepsis und Milzerkrankungen. Schlussfolgerung SCD in Deutschland lässt sich mit Routinedaten der größten gesetzlichen Krankenkasse plausibel darstellen. Derzeit wird die Krankheit zu selten frühzeitig erkannt. Die Zeit bis zur Erkennung ließe sich entscheidend verkürzen durch Aufnahme von SCD in das Neugeborenenscreening. Bis eine solche Lösung erreicht ist, sollten Eltern mit Migrationshintergrund und Fachleute ihre Aufmerksamkeit für SCD erhöhen.

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“…Despite reductions in morbidity and mortality associated with early screening [1][2][3], sickle cell disease (SCD) is still marked by high utilization of medical resources. However, the nature and the costs of SCD care, particularly among adults, are not well understood.…”

Section: Introductionmentioning

confidence: 99%

The cost of health care for children and adults with sickle cell disease

et al. 2009

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Although sickle cell disease (SCD) is marked by high utilization of medical resources, the full cost of care for patients with SCD, including care not directly related to SCD, is unknown. The purpose of this study was to estimate the total cost of medical care for a population of children and adults with SCD. We used data from individuals diagnosed with SCD enrolled in the Florida Medicaid program during 2001-2005 to estimate total, SCD-related, and non-SCD-related cost per patient-month based on patient age at the time of health care use. Across the 4,294 patient samples, total health care costs generally rose with age, from $892 to $2,562 per patient-month in the 0-9-and 50-64-year age groups, respectively. Average cost per patient-month was $1,389. Overall, 51.8% of care was directly related to SCD, the majority of which (80.5%) was associated with inpatient hospitalizations. Notably, non-SCD-related costs were substantially higher than those reported for the general US population. These results suggest a discounted (3% discount rate) lifetime cost of care averaging $460,151 per patient with SCD. Interventions designed to prevent SCD complications and avoid hospitalizations may reduce the significant economic burden of the disease. Am. J.

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The effects of neonatal screening for sickle cell disorders on lifetime treatment costs and early deaths avoided: a modelling approach

Cited by 12 publications

References 48 publications

A randomized controlled trial to assess the clinical and cost effectiveness of a nurse-led Antenatal Asthma Management Service in South Australia (AAMS study)

A randomized controlled trial to assess the clinical and cost effectiveness of a nurse-led Antenatal Asthma Management Service in South Australia (AAMS study)

Sichelzellkrankheit unter Neugeborenen in Deutschland: Eine Studie an Routinedaten der AOK

The cost of health care for children and adults with sickle cell disease

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