Randomised clinical trials in perinatal health care: a cost-effective investment.

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dc.contributor.author Pham, Clarabelle T en
dc.contributor.author Karnon, Jonathan D en
dc.contributor.author Middleton, Philippa F en
dc.contributor.author Bloomfield, Francis en
dc.contributor.author Allan, Katie en
dc.contributor.author Crowther, Caroline en
dc.contributor.author Mol, Ben W en
dc.date.accessioned 2018-10-10T20:58:06Z en
dc.date.issued 2017-09 en
dc.identifier.issn 0025-729X en
dc.identifier.uri http://hdl.handle.net/2292/40532 en
dc.description.abstract OBJECTIVE:To compare the health and economic impacts of implementing efficacious treatment interventions with maintaining standard practice in maternal and perinatal health care. DESIGN AND SETTING:We identified randomised clinical trials (RCTs) in the Perinatal Society of Australia and New Zealand trials database that commenced recruitment during 2008 and had completed recruitment by 2015. Data from clinical trial registries and publications were collated to calculate the potential cost savings achievable by implementing efficacious treatment interventions. MAIN OUTCOME MEASURE:Projected net cost savings over 5 years. RESULTS:Twenty-three eligible RCTs covering a range of behavioural and clinical interventions were identified, of which six reported interventions superior to standard practice (four trials) or placebo (two). The outcomes (but not the costs) of 17 trials were excluded from analysis (no difference between intervention and comparator groups in seven trials, recruitment problems in six, findings not yet published in four). The total funding amount for the 23 trials was $20.3 million; the potential cost savings over 5 years if the findings of the six trials reporting superior interventions were implemented was estimated to be $26.3 million if 10% of the eligible populations received the effective interventions, and $262.8 million with 100% implementation. CONCLUSIONS:Our retrospective analysis highlights the value of research in perinatal care and the importance of implementing positive findings for realising its value. Future trials in maternal and perinatal health care may provide significant returns on investment by informing clinical practice, improving patient outcomes and reducing health care costs. en
dc.format.medium Print en
dc.language eng en
dc.relation.ispartofseries The Medical journal of Australia en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Humans en
dc.subject Perinatal Care en
dc.subject Prenatal Care en
dc.subject Retrospective Studies en
dc.subject Pregnancy en
dc.subject Cost-Benefit Analysis en
dc.subject Health Care Costs en
dc.subject Australia en
dc.subject New Zealand en
dc.subject Female en
dc.subject Randomized Controlled Trials as Topic en
dc.title Randomised clinical trials in perinatal health care: a cost-effective investment. en
dc.type Journal Article en
dc.identifier.doi 10.5694/mja16.01178 en
pubs.issue 7 en
pubs.begin-page 289 en
pubs.volume 207 en
dc.rights.holder Copyright: The author en
dc.identifier.pmid 28954615 en
pubs.end-page 293 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Journal Article en
pubs.elements-id 679311 en
pubs.org-id Liggins Institute en
pubs.org-id LiFePATH en
dc.identifier.eissn 1326-5377 en
pubs.record-created-at-source-date 2017-09-29 en
pubs.dimensions-id 28954615 en

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