UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Cost-effectiveness of screening tools for identifying depression in early pregnancy: a decision tree model

Heslin, Margaret; Jin, Huajie; Trevillion, Kylee; Ling, Xiaoxiao; Nath, Selina; Barrett, Barbara; Demilew, Jill; ... Byford, Sarah; + view all (2022) Cost-effectiveness of screening tools for identifying depression in early pregnancy: a decision tree model. BMC Health Services Research , 22 (1) , Article 774. 10.1186/s12913-022-08115-x. Green open access

[thumbnail of Ling_Cost-effectiveness of screening tools for identifying depression in early pregnancy_VoR.pdf]
Preview
Text
Ling_Cost-effectiveness of screening tools for identifying depression in early pregnancy_VoR.pdf - Published Version

Download (1MB) | Preview

Abstract

BACKGROUND: Although the effectiveness of screening tools for detecting depression in pregnancy has been investigated, there is limited evidence on the cost-effectiveness. This is vital in providing full information to decision makers. This study aimed to explore the cost-effectiveness of different screening tools to identify depression in early pregnancy compared to no screening. METHODS: A decision tree was developed to model the identification and treatment pathways of depression from the first antenatal appointment to 3-months postpartum using the Whooley questions, the Edinburgh Postnatal Depression Scale (EPDS) and the Whooley questions followed by the EPDS, compared to no screening. The economic evaluation took an NHS and Personal Social Services perspective. Model parameters were taken from a combination of sources including a cross-sectional survey investigating the diagnostic accuracy of screening tools, and other published literature. Cost-effectiveness was assessed in terms of the incremental cost per quality adjusted life years (QALYs). Cost-effectiveness planes and cost-effectiveness acceptability curves were produced using a net-benefit approach based on Monte Carlo simulations of cost-outcome data. RESULTS: In a 4-way comparison, the Whooley, EPDS and Whooley followed by the EPDS each had a similar probability of being cost-effective at around 30% for willingness to pay values from £20,000–30,000 per QALY compared to around 20% for the no screen option. CONCLUSIONS: All three screening approaches tested had a higher probability of being cost-effective than the no-screen option. In the absence of a clear cost-effectiveness advantage for any one of the three screening options, the choice between the screening approaches could be made on other grounds, such as clinical burden of the screening options. Limitations include data availability and short time horizon, thus further research is needed.

Type: Article
Title: Cost-effectiveness of screening tools for identifying depression in early pregnancy: a decision tree model
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s12913-022-08115-x
Publisher version: https://doi.org/10.1186/s12913-022-08115-x
Language: English
Additional information: © 2022 BioMed Central Ltd. This article is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).
Keywords: Cost-effectiveness, Decision analytic model, Depression, Pregnancy, Screening, Whooley, EPDS
UCL classification: UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Statistical Science
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10150889
Downloads since deposit
24Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item