HTA Long-term economic and health-related consequences of short term outcomes in evaluation of perinatal interventions
Health Technology Assessment
Evaluation of perinatal interventions requires assessment of both neonatal as well as maternal outcomes. Since serious (neurological) sequelae from perinatal complications become manifest only after several years, appropriate assessment of neonatal outcome requires follow-up of the child of at least 2 years and preferably even longer. However, such follow-up is very expensive, and falls outside the funding for the limited period of time of most research programs. As a consequence, in many prospective studies in perinatal medicine neither long-term health nor economic consequences can be addressed, or they are described qualitatively rather than integrated quantitatively in the economic analyses. Instead, short term outcomes are reported, for which long term clinical and economic implications are only implicitly known. Examples of such short term outcomes are respiratory distress syndrome, seizures or maternal puerperal infections. Long term consequences of a short term perinatal outcome may be different in case of a multiple pregnancy or preterm delivery.
Multivariable prediction models can be used to estimate long term consequences of a short term outcomes in combination with other covariates. Such estimates (including model uncertainties) could subsequently be integrated in future evaluations of perinatal interventions, thereby increasing both efficiency as well as validity.
This study aims to develop long term prediction models for different short term perinatal outcomes. These models will be developed using data from a cohort study of preterm and/or SGA children born in 1983 (POPS trial), for which follow-up assessments were done at ages 2, 5, 9, 10, 14 and 19. Internal validation will be performed to correct for bias due to overfit. Other datasets containing relevant outcome assessments at the medium term will be used to externally validate these models.
M.J. Teune, AMC Amsterdam
Dr. B.C. Opmeer, AMC Amsterdam
Dr. A.G. van Wassenaer, AMC Amsterdam
Prof. B.W. Mol, MMC Veldhoven