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Saturday, August 31, 2013

Trailers (57): Noninvasive fetal RhD typing for prophylaxis

Hawk et al. Costs and clinical outcomes of noninvasive fetal RhD typing for targeted prophylaxis

Why should you read about this topic?

Because antenatal testing is being re-defined by cell-free serum genomic DNA analysis

What were the authors trying to do?

To compare the costs of three different approaches to RhD immunization prophylaxis: routine antenatal and postpartum anti-D immune globulin prophylaxis; noninvasive fetal RhD typing with targeted prophylaxis; and, no testing or prophylaxis.

Who participated and in what setting?

Published literature

What was the study design?

Decision tree cost analysis

What were the main outcome measures?

USD

What were the results?

Routine antenatal and postpartum anti-D immune globulin prophylaxis is less expensive than noninvasive fetal RhD typing.

What is the most interesting image in the paper?

Table 3

What were the study strengths and weaknesses?

Strengths:  sensitivity analysis. Weaknesses: the model is only as good as the assumptions; costs derived from charges

What does the study contribute for your practice?

Until noninvasive fetal RhD typing costs less than $119, the conventional approach to prophylaxis is the most economical.