Table 5.
Summary of Results from Monte Carlo Simulation
| Monte Carlo simulation | Trial of labor | Cesarean delivery on maternal request (CDMR)a |
|---|---|---|
| Cost, mean (95% CIa) | $13,283 ($7,861-$23,829) | $14,259 ($8,964-$24,002) |
| Quality-adjusted life-years (QALY), mean (95% CI) | 57.87 (56.97-58.46) | 58.21 (57.43-58.67) |
| Average cost-effectiveness ratio, mean (95% CI) | $230/QALY ($135/QALY-$414/QALY) | $245/QALY ($153/QALY-$417/QALY) |
| ΔCost,b mean (95% CI) | $976 (−$7,863-$7,935) | |
| ΔQALY,c mean (95% CI) | 0.35 (−0.24-1.10) | |
| Most significant parametersd | Effect of 1 SDe increase in parameter on ΔCostb | Effect of 1 SDe increase in parameter on ΔQALYc |
|---|---|---|
| Probability of stress urinary incontinence (SUI) after CDMR (SDe = 0.09) | $2,509 | −0.17 |
| Probability of SUI after spontaneous vaginal delivery (SDe = 0.07) | −$1,711 | 0.10 |
| Cost of neonatal morbidity (SDe = 47,589) | $924 | n/a |
| Cost of CDMR (SDe = 625) | $625 | n/a |
| Annual routine care cost for SUI (SDe = 1,009) | −$1,080 | n/a |
| Age of pelvic floor disorder onset (SDe = 5.20) | $817 | −0.11 |
| Utility of CDMR (SDe = 0.13) | n/a | 0.13 |
| Utility of pelvic organ prolapse (SDe = 0.13) | n/a | −0.09 |
| Utility of SUI (SDe = 0.10) | n/a | −0.10 |
a
CI, confidence interval.
b
ΔCost, cost of CDMR − cost of trial of labor.
c
ΔQALY, QALY of CDMR − QALY of trial of labor.
d
All these parameters are statistically significant at 0.05 level.
e
SD, standard deviation. These are estimated SDs of the parameters based on the simulation (n = 5000 iterations).