Cargando…
Economic impact of using maternal plasma cell‐free DNA testing to guide further workup in recurrent pregnancy loss
OBJECTIVE: We have previously demonstrated that maternal‐plasma cell‐free DNA (cfDNA)‐testing can detect chromosomal anomalies in recurrent pregnancy loss (RPL) with 81.8% sensitivity and 90.3% specificity. Here we assess whether this is cost effective in guiding further workup in RPLs. METHOD: A de...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518071/ https://www.ncbi.nlm.nih.gov/pubmed/34002411 http://dx.doi.org/10.1002/pd.5972 |
_version_ | 1784584144843440128 |
---|---|
author | Peng, Siyang Bhatt, Sucheta Borrell, Antoni Yaron, Yuval |
author_facet | Peng, Siyang Bhatt, Sucheta Borrell, Antoni Yaron, Yuval |
author_sort | Peng, Siyang |
collection | PubMed |
description | OBJECTIVE: We have previously demonstrated that maternal‐plasma cell‐free DNA (cfDNA)‐testing can detect chromosomal anomalies in recurrent pregnancy loss (RPL) with 81.8% sensitivity and 90.3% specificity. Here we assess whether this is cost effective in guiding further workup in RPLs. METHOD: A decision‐analytic model was developed to compare the cost of various RPL management pathways: (1) current American Society for Reproductive Medicine (ASRM) RPL workup; (2) microarray or karyotyping analysis of products of conception (POCs) and RPL workup only for euploid cases; and (3) cfDNA testing and RPL workup only for euploid cases. Sample accessibility, failure rates, and sensitivity were specified for each test. Costs of sample collection, genetic tests, and RPL workup were considered. Analysis outcomes included detection rate of chromosomal anomaly and cost per patient tested. RESULTS: In comparison to existing cytogenetic testing on POCs, cfDNA testing pathway allowed for better sample accessibility with a lower cost per patient. In addition, using cfDNA to guide further workup significantly increases the number of causative fetal chromosome anomalies detected, reducing the number of patients undergoing unnecessary workup resulting in an overall cost savings. CONCLUSION: Our study showed that inclusion of cfDNA testing is a cost‐effective approach to guide RPL workup. |
format | Online Article Text |
id | pubmed-8518071 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-85180712021-10-21 Economic impact of using maternal plasma cell‐free DNA testing to guide further workup in recurrent pregnancy loss Peng, Siyang Bhatt, Sucheta Borrell, Antoni Yaron, Yuval Prenat Diagn Original Articles OBJECTIVE: We have previously demonstrated that maternal‐plasma cell‐free DNA (cfDNA)‐testing can detect chromosomal anomalies in recurrent pregnancy loss (RPL) with 81.8% sensitivity and 90.3% specificity. Here we assess whether this is cost effective in guiding further workup in RPLs. METHOD: A decision‐analytic model was developed to compare the cost of various RPL management pathways: (1) current American Society for Reproductive Medicine (ASRM) RPL workup; (2) microarray or karyotyping analysis of products of conception (POCs) and RPL workup only for euploid cases; and (3) cfDNA testing and RPL workup only for euploid cases. Sample accessibility, failure rates, and sensitivity were specified for each test. Costs of sample collection, genetic tests, and RPL workup were considered. Analysis outcomes included detection rate of chromosomal anomaly and cost per patient tested. RESULTS: In comparison to existing cytogenetic testing on POCs, cfDNA testing pathway allowed for better sample accessibility with a lower cost per patient. In addition, using cfDNA to guide further workup significantly increases the number of causative fetal chromosome anomalies detected, reducing the number of patients undergoing unnecessary workup resulting in an overall cost savings. CONCLUSION: Our study showed that inclusion of cfDNA testing is a cost‐effective approach to guide RPL workup. John Wiley and Sons Inc. 2021-05-24 2021-09 /pmc/articles/PMC8518071/ /pubmed/34002411 http://dx.doi.org/10.1002/pd.5972 Text en © 2021 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Peng, Siyang Bhatt, Sucheta Borrell, Antoni Yaron, Yuval Economic impact of using maternal plasma cell‐free DNA testing to guide further workup in recurrent pregnancy loss |
title | Economic impact of using maternal plasma cell‐free DNA testing to guide further workup in recurrent pregnancy loss |
title_full | Economic impact of using maternal plasma cell‐free DNA testing to guide further workup in recurrent pregnancy loss |
title_fullStr | Economic impact of using maternal plasma cell‐free DNA testing to guide further workup in recurrent pregnancy loss |
title_full_unstemmed | Economic impact of using maternal plasma cell‐free DNA testing to guide further workup in recurrent pregnancy loss |
title_short | Economic impact of using maternal plasma cell‐free DNA testing to guide further workup in recurrent pregnancy loss |
title_sort | economic impact of using maternal plasma cell‐free dna testing to guide further workup in recurrent pregnancy loss |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518071/ https://www.ncbi.nlm.nih.gov/pubmed/34002411 http://dx.doi.org/10.1002/pd.5972 |
work_keys_str_mv | AT pengsiyang economicimpactofusingmaternalplasmacellfreednatestingtoguidefurtherworkupinrecurrentpregnancyloss AT bhattsucheta economicimpactofusingmaternalplasmacellfreednatestingtoguidefurtherworkupinrecurrentpregnancyloss AT borrellantoni economicimpactofusingmaternalplasmacellfreednatestingtoguidefurtherworkupinrecurrentpregnancyloss AT yaronyuval economicimpactofusingmaternalplasmacellfreednatestingtoguidefurtherworkupinrecurrentpregnancyloss |