B1.6 by xiaohuicaicai

VIEWS: 3 PAGES: 2

									Preference Elicitation and Assessment of Technologies
(PEAT) Programme
Project No:               B1.6                                                   Projects completed

Project Title:            A cluster randomised trial to investigate the use of decision aid for the
                          diagnosis of active labour in term pregnancy.

Grant Applicants /        Cheyne, H., Niven, C. (University of Stirling) Hundley, V. (University of
Principal Investigators   Stirling & Aberdeen) Dowding, D. (University of York) Greer, I.
(place of work):          (University of Glasgow) Bland, M. (University of York) Aucott, L.
                          (Department of Population Health, University of Aberdeen) McNamee, P.
                          (HERU)

HERU Investigators:       McNamee, P and Scotland, G.

HERU Research             Assessment of Technologies
Theme:

Source of Funding and     CSO - £201,538
Total Awarded:

Amount of HERU            £12,031
Funding:

Objectives:               To assess the effectiveness and cost-effectiveness of a decision aid for the
                          diagnosis of active labour in term pregnancy.

Outline:                  Admission of women who are not in labour accounts for 10% to 30% of
                          maternity admissions. This is an unnecessary burden on resources.
                          Women admitted in latent labour have the appearance of a longer labour
                          and are more likely to receive a cascade of intervention starting with
                          administration of oxytocin and including caesarean section. A previous
                          study developed and tested a decision aid for diagnosis of active labour
                          and assessed the feasibility of conducting a cluster randomised trial. This
                          study went on to conduct the cluster randomised controlled trial, recruiting
                          twelve maternity units with an average cluster size of 200 women, with
                          units randomly allocated to receive either the decision aid or standard
                          care. Outcomes included use of oxytocin, interventions and analgesia in
                          labour, mode of delivery. NHS costs and costs to women were also
                          assessed.

Outcome and               This was the largest ever randomised controlled trial of an initiative aimed
Translation:              at reducing early admissions to the labour ward. However, the proposed
                          algorithm was not effective in changing use of resources or improving
                          outcomes. As a result there are no plans to implement the algorithm.
                          Future initiatives to reduce early admission to the labour ward need to
                          focus on the perspectives of women as well as those of clinicians.
Start Date:            April 2005
                       2 years
Duration of Project:

Project Phase:

Publications:          Cheyne, H., Terry, R., Niven, C., Dowding, D., Hundley, V. and
                       McNamee, P. Should I come in now? A study of women's early labour
                       experiences. British Midwifery Journal. 2007; 15(10): 604-625.

                       Cheyne, H., Hundley, V., Dowding, D., Bland, J.M., McNamee, P.,
                       Greer, I.A., Styles, M., Barnett, C.A., Scotland, G.S. and Niven, C.A.
                       Effects of algorithm for diagnosis of active labour: a cluster randomised
                       trial. British Medical Journal 2008; 337(7683): a2396

                       Cheyne, H., Hundley, V., Dowding, D., Niven, C., Greer, I., Bland, J.M.,
                       Aucott, L. and McNamee, P. A cluster randomised trial to investigate the
                       use of a decision aid for the diagnosis of active labour in term pregnancy
                       (The Early Labour Study in Scotland). Chief Scientist Office Final Report.
                       July 2007.

Other Dissemination    Cheyne, H., Hundley, V., Dowding, D., Aucott, L., McNamee, P., Styles,
Activities:            M., Barnett. C.A., Greer, I., Bland, M. and Niven, K. The Early Labour
                       Study in Scotland: Measuring the Benefits of an algorithm for diagnosis of
                       active labour using Discrete Choice Experiments. Triennial International
                       Confederation of Midwives Congress. Glasgow. 2008.

                       Cheyne, H. and McNamee, P. The early labour study in Scotland –
                       TELSIS. Dugald Baird Centre. University of Aberdeen, 2008.

                       Scotland, G.S., and McNamee, P. Measuring the Benefits of an algorithm
                       for diagnosis of active Labour: Results from a Discrete Choice
                       Experiment (DCE). Accepted as part of The Early Labour Study in
                       Scotland (TELSiS) symposium. Congress of the International
                       Confederation of Midwives. Glasgow, June 2008.

                       Scotland, G.S., McNamee, P. and Ryan, M. Should we be concerned
                       about learning effects in discrete choice experiments? European
                       Conference on Health Economics. University of Rome July 2008.

								
To top