OBJECTIVES: To determine the cost effectiveness of a universal prenatal screening program for alpha- and beta-thalassaemia. METHODS: We retrospectively reviewed our program from 1998 to 2002, and calculated the direct and indirect costs of various components. RESULTS: 18,936 women were screened at our prenatal clinic and 153 couples were subsequently referred to our Prenatal Diagnostic Centre for counselling and further investigations. In addition, there were 238 tertiary referrals and 157 self-referrals. After investigations, 84 fetuses were at risk of beta-thalassaemia major/beta-E thalassaemia, 19 of them were affected and 18 were aborted. The total expenditure on our program (HK 10.0 million dollars) would be less than the postnatal service costs (HK 40.4 million dollars) for 18beta-thalassaemia major fetuses if they were born. Of 361 women at risk of carrying a homozygous alpha0-thalassaemia fetus, 311 (86.2%) opted for the indirect approach (using serial ultrasound examinations to exclude Hb Bart's disease), and 76 (24.5%) subsequently underwent an invasive test for a definitive diagnosis. The sensitivity and false positive rate of this indirect approach was 100.0% and 2.9% respectively. CONCLUSION: It is cost effective to run a universal prenatal screening program in an area where both beta-thalassaemia and alpha-thalassaemia are prevalent. The indirect approach can effectively avoid an invasive test in unaffected pregnancies. Copyright 2004 John Wiley & Sons, Ltd.
OBJECTIVES: To determine the cost effectiveness of a universal prenatal screening program for alpha- and beta-thalassaemia. METHODS: We retrospectively reviewed our program from 1998 to 2002, and calculated the direct and indirect costs of various components. RESULTS: 18,936 women were screened at our prenatal clinic and 153 couples were subsequently referred to our Prenatal Diagnostic Centre for counselling and further investigations. In addition, there were 238 tertiary referrals and 157 self-referrals. After investigations, 84 fetuses were at risk of beta-thalassaemia major/beta-E thalassaemia, 19 of them were affected and 18 were aborted. The total expenditure on our program (HK 10.0 million dollars) would be less than the postnatal service costs (HK 40.4 million dollars) for 18beta-thalassaemia major fetuses if they were born. Of 361 women at risk of carrying a homozygous alpha0-thalassaemia fetus, 311 (86.2%) opted for the indirect approach (using serial ultrasound examinations to exclude Hb Bart's disease), and 76 (24.5%) subsequently underwent an invasive test for a definitive diagnosis. The sensitivity and false positive rate of this indirect approach was 100.0% and 2.9% respectively. CONCLUSION: It is cost effective to run a universal prenatal screening program in an area where both beta-thalassaemia and alpha-thalassaemia are prevalent. The indirect approach can effectively avoid an invasive test in unaffected pregnancies. Copyright 2004 John Wiley & Sons, Ltd.
Authors: David H K Chui; Melody J Cunningham; Hong-Yuan Luo; Lawrence C Wolfe; Ellis J Neufeld; Martin H Steinberg Journal: Blood Date: 2006-02-15 Impact factor: 22.113
Authors: Jeffrey Fong Ting Chau; Mullin Ho Chung Yu; Martin Man Chun Chui; Cyrus Chun Wing Yeung; Aaron Wing Cheung Kwok; Xuehan Zhuang; Ryan Lee; Jasmine Lee Fong Fung; Mianne Lee; Christopher Chun Yu Mak; Nicole Ying Ting Ng; Claudia Ching Yan Chung; Marcus Chun Yin Chan; Mandy Ho Yin Tsang; Joshua Chun Ki Chan; Kelvin Yuen Kwong Chan; Anita Sik Yau Kan; Patrick Ho Yu Chung; Wanling Yang; So Lun Lee; Godfrey Chi Fung Chan; Paul Kwong Hang Tam; Yu Lung Lau; Kit San Yeung; Brian Hon Yin Chung; Clara Sze Man Tang Journal: NPJ Genom Med Date: 2022-03-21 Impact factor: 8.617