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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...

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Autores principales: Peng, Siyang, Bhatt, Sucheta, Borrell, Antoni, Yaron, Yuval
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
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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.
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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
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