Table 7.
Results of deterministic sensitivity analysis for the base‐case strategies (high risk of spontaneous preterm delivery (sPTD) indicated by sonographic cervical length (CL) ≤ 25 mm), according to CL screening at 18 + 0 to 20 + 6 weeks (Cx1) and at 21 + 0 to 23 + 6 weeks (Cx2)
| Sensitivity analysis | Preferred strategy at Cx1* | Preferred strategy at Cx2* |
|---|---|---|
| Physician visits | ||
| Every 2 weeks until 34 + 0 weeks | Nullipara screening | No screening, treat high‐risk group |
| Once a month until 34 + 0 weeks | Low‐risk‐based screening | No screening, treat high‐risk group |
| Productivity loss owing to sick leave during pregnancy | ||
| 50% of women | No screening | No screening |
| 100% of women | No screening | No screening |
| Progesterone effectiveness† | ||
| 5% and 1.7%‡ | No screening, treat high‐risk group | No screening |
| 15% and 5%‡ | No screening, treat high‐risk group | No screening, treat high‐risk group |
| 45% and 15%‡ | Low‐risk‐based screening | Low‐risk‐based screening |
| 55% and 18.3%‡ | Low‐risk‐based screening | Low‐risk‐based screening |
| Productivity loss owing to parental leave | ||
| Low (−20%) | Low‐risk‐based screening | No screening, treat high‐risk group |
| High (+ 20%) | Low‐risk‐based screening | No screening, treat high‐risk group |
| Cost of neonatal care | ||
| Low (−20%) | Low‐risk‐based screening | No screening, treat high‐risk group |
| High (+ 20%) | Low‐risk‐based screening | No screening, treat high‐risk group |
| Type of perspective | ||
| Healthcare perspective (does not include societal costs) | Low‐risk‐based screening | No screening, treat high‐risk group |
| Discount rate | ||
| Low (0%) | Low‐risk‐based screening | Low‐risk‐based screening |
| High (5%) | Nullipara screening | No screening, treat high‐risk group |
The preferred strategy is based on the maximum acceptable cost per gained quality‐adjusted life year being 500 000 Swedish krona (corresponding to 56 000 US dollars) according to the Swedish National Board of Health and Welfare 53 .
The spectrum of effectiveness of progesterone for prevention of sPTD between 33 + 0 and 36 + 6 weeks was modulated in the same proportion as the effect for prevention of sPTD < 33 + 0 weeks.
The first number indicates the estimated effectiveness of progesterone to reduce sPTD < 33 weeks and the second number indicates the estimated effectiveness of progesterone to reduce sPTD at 33 + 0 to 36 + 6 weeks.