QALYs in obstetrics: not the whole story

摘要

Universal ultrasound scanning for macrosomia... is not cost-effective... is not warranted.' Wastlund et al. offer this conclusion from a cost-effectiveness analysis (CEA) of universal versus selective screening for macrosomia with ultrasound (BJOG 2019; 126: 1243-50). This decisive statement reveals interesting observations about CEA in obstetrics. The authors conclude that universal screening for macrosomia is not cost-effective based on a widely accepted threshold in the UK: €20,000-30,000 per quality-adjusted life year (QALY). As the incremental cost-effectiveness ratio (ICER) of universal screening with induction of labour for macrosomia was €52,719 per QALY when compared with selective ultrasound plus labour induction, it is not considered to be cost-effective.