Model nákladové efektivity plošného screeningu poruchy funkce štítné žlázy v těhotenství pro Českou republiku

Tužil, Jan

Model nákladové efektivity plošného screeningu poruchy funkce štítné žlázy v těhotenství pro Českou republiku Cost-effectiveness model of universal screening for thyroid disorders in pregnancy for the Czech Republic Disertační práce English Abstract Introduction: Subclinical hypothyroidism affects approximately 5% of pregnant women in the Czech Republic and is associated with a number of health risks for both mother and child. The negative effects can be prevented by effective and safe hormone replacement therapy. Although subclinical hypothyroidism can be diagnosed solely by blood tests, only 45% of pregnant women in the Czech Republic are currently tested. Thyroid function screening (thyrotropin; TSH) can be accompanied by thyroid autoimmunity testing (anti-thyroid peroxidase antibodies; anti-TPO) to predict increased risk of postpartum thyroiditis. Aims: The aim is to model the cost-effectiveness, budgetary impact and impact on routine practice of the introduction of universal TSH screening (versus the current state of things) and an addition of the universal anti-TPO screening (versus TSH screening alone). Method: The cost-benefit ratio, budget impact, and impact on routine practice were modelled using a decision tree for implementation of the TSH test and a nested decision tree for the addition of the...

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