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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Cervical ripening at home or in-hospital-prospective cohort study and process evaluation (CHOICE) study: a protocol
Author(s): Stock, Sarah Jane
Bhide, Amarnath
Richardson, Heather
Black, Mairead
Yuill, Cassandra
Harkness, Mairi
Reid, Maggie
Wee, Fiona
Cheyne, Helen
McCourt, Christine
Rana, Dikshyanta
Boyd, Kathleen Anne
Sanders, Julia
Heera, Neelam
Huddleston, Jane
Issue Date: May-2021
Date Deposited: 26-May-2021
Citation: Stock SJ, Bhide A, Richardson H, Black M, Yuill C, Harkness M, Reid M, Wee F, Cheyne H, McCourt C, Rana D, Boyd KA, Sanders J, Heera N & Huddleston J (2021) Cervical ripening at home or in-hospital-prospective cohort study and process evaluation (CHOICE) study: a protocol. BMJ Open, 11 (5), Art. No.: e050452.
Abstract: Introduction The aim of the cervical ripening at home or in-hospital—prospective cohort study and process evaluation (CHOICE) study is to compare home versus in-hospital cervical ripening to determine whether home cervical ripening is safe (for the primary outcome of neonatal unit (NNU) admission), acceptable to women and cost-effective from the perspective of both women and the National Health Service (NHS). Methods and analysis We will perform a prospective multicentre observational cohort study with an internal pilot phase. We will obtain data from electronic health records from at least 14 maternity units offering only in-hospital cervical ripening and 12 offering dinoprostone home cervical ripening. We will also conduct a cost-effectiveness analysis and a mixed methods study to evaluate processes and women/partner experiences. Our primary sample size is 8533 women with singleton pregnancies undergoing induction of labour (IOL) at 39+0 weeks’ gestation or more. To achieve this and contextualise our findings, we will collect data relating to a cohort of approximately 41 000 women undergoing IOL after 37 weeks. We will use mixed effects logistic regression for the non-inferiority comparison of NNU admission and propensity score matched adjustment to control for treatment indication bias. The economic analysis will be undertaken from the perspective of the NHS and Personal Social Services (PSS) and the pregnant woman. It will include a within-study cost-effectiveness analysis and a lifetime cost–utility analysis to account for any long-term impacts of the cervical ripening strategies. Outcomes will be reported as incremental cost per NNU admission avoided and incremental cost per quality adjusted life year gained. Research ethics approval and dissemination CHOICE has been funded and approved by the National Institute of Healthcare Research Health Technology and Assessment, and the results will be disseminated via publication in peer-reviewed journals. Trial registration number ISRCTN32652461.
DOI Link: 10.1136/bmjopen-2021-050452
Rights: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:
Notes: Additional co-authors: Fiona Denison, Dharmintra Pasupathy, Neena Modi, Gordon Smith, John Norrie
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