Article Figures & Tables
Figures
- Figure 1:
Simplified representation of hybrid model. The thick lines indicate the nodes from which clones are specified. Note: ON = ophthalmia neonatorum, STI = sexually transmitted infection. *Cure or treatment failure refers to treatment of maternal STI and therefore probability of newborn exposure.
- Figure 2:
Cost-effectiveness acceptability curve. Note: ON = ophthalmia neonatorum, QALY = quality-adjusted life-year.
Tables
Parameter Expected value Probability distribution* Source Clinical parameters Prevalence of maternal infection, % 10 Chlamydia 1.90 Dirichlet (40, 2, 2, 2178) Gonorrhea 0.20 Coinfection with chlamydia and gonorrhea 0.10 No maternal infection 97.90 Prenatal STI screening results, % 8 False positive 4.13 Dirichlet (33, 1, 12, 754) False negative 0.12 True positive 1.50 True negative 94.25 Probability of ON in infant exposed to maternal infection, % Chlamydia 15.00 Beta (156, 899) 11 Gonorrhea 40.00 Beta (3688, 5531) 4 Risk of ON treatment failure and blindness, % Chlamydia 14.30 Beta (326, 1850) 11 Gonorrhea 3.46 Beta (145, 4045) 12 Relative risk of ON with prophylactic erythromycin ointment ON caused by gonorrhea 0.19 LogNormal (0.07, 0,50) 13 ON caused by chlamydia 0.93 LogNormal (0.48, 1.79) 14 Probability of adverse events of prophylaxis, % 10 Beta (127, 1142) 15,16 Cost parameters, $ Erythromycin ON prophylaxis 0.90 Fixed 17 Adverse events from prophylaxis 33.70 Fixed 18 Gonococcal ON 2871.10 Gamma (179.44, 16) 8 Chlamydia ON 574.47 Gamma (35.90, 16) 8 Blindness 19 370.00 Gamma (4842.50, 16) 19 Utility values Healthy term infant 0.876 Normal (0.876, 0.045) 14 Healthy, aged ≥ 12+ yr 0.912–0.699 Fixed 20 Disutility from blindness, aged 0–16 yr 0.329 Normal (0.329, 0.036) 14 Disutility from blindness, adult 0.208 Normal (0.208, 0.013) 21 Note: ON = ophthalmia neonatorum, STI = sexually transmitted infection.
↵* Dirichlet (α, β, γ, δ) relates to a Dirichlet distribution, where α, β, γ and δ represent the number of individuals with the inclusive events. Beta (α, β) relates to a beta distribution, where α represents the number of individuals with events and β represents the number of those without events. Gamma (α, β) relates to a gamma distribution, where α represents the shape and β represents the scale. Normal (α, β) relates to a normal distribution, where α represents the mean and β represents the standard error. LogNormal (α, β) relates to a log normal distribution, where α represents the 2.5 percentile and β represents the 97.5 percentile.
- Table 2:
Disaggregated results from base case analysis comparing prophylaxis for ophthalmia neonatorum with no prophylaxis
Variable ON prophylaxis No prophylaxis Cost per infant, $ Prophylaxis 3.77 0 Adverse events 3.38 0 Chlamydia transmission of ON 0.12 0.12 Gonorrheal transmission of ON 0.03 0.15 Lifetime cost of blindness 0.44 0.47 Total cost 7.73 0.75 Outcomes Short-term QALYs,* per infant 0.876485 0.876484 Blindness, per 100 000 infants 2.3 2.4 Long-term QALYs,† per infant 41.181768 41.181749 - Table 3:
Overall results of base analysis comparing prophylaxis for ophthalmia neonatorum with no prophylaxis
Variable ON prophylaxis No prophylaxis Difference ICER, $ Total cost, $ 7.73 0.75 6.99 Short-term QALYs 0.876485 0.876484 0.000001 12 348 383 Incidence of blindness 0.000023 0.000024 0.000002 4 078 761 Long-term QALYs 41.181768 41.181749 0.000020 355 798 Note: ICER = incremental cost-effectiveness ratio, ON = ophthalmia neonatorum, QALY = quality-adjusted life-year.
- Table 4:
Results of scenario analyses comparing prophylaxis for ophthalmia neonatorum with no prophylaxis
Analysis ICER per QALY gained for ON prophylaxis v. no prophylaxis, $ Base case 355 798 0% discount rate 207 801 3% discount rate 526 467 1-year time horizon 12 346 383 10-year time horizon 1 325 046 20-year time horizon 826 645 Note: ICER = incremental cost-effectiveness ratio, ON = ophthalmia neonatorum, QALY = quality-adjusted life-year.
Parameter Expected value of perfect partial information per pregnant person, $ Individual parameters Probability of false-negative result with STI testing 0.0041 Relative reduction in transmission with ON prophylaxis with prevalent chlamydia 0.0388 All other parameters 0 Parameter groups Accuracy of STI testing 0.0369 Benefits and risks from ON prophylaxis 0.0573 All other groups (disease prevalence and natural history, costs, utilities) 0 Note: ON = ophthalmia neonatorum, STI = sexually transmitted infection.
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