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Worldwide, maternal mortality is mostly caused by avoidable or treatable health complications, despite the progress made in maternal health. High-quality care focuses on a standardised and patient-centred approach. In this light, care bundles, which are sets of evidence-based practices, were introduced to improve the quality of care and maternal outcomes. The existing reviews on care bundles focus on specific conditions, and there is, to our knowledge, no comprehensive systematic review on the effectiveness and evidence-based character of care bundles on multiple maternal outcomes. This systematic review aims to describe maternal care bundles on labour and birth, to assess their effectiveness on maternal outcomes and to evaluate the evidence-based character of their interventions.
This systematic review will include randomised controlled trials, quasi-randomised studies, cohort studies, case-control studies, controlled before-and-after studies and interrupted-time-series studies, starting from 2001, focused on labour and childbirth stages, addressing care bundles that include multiple conditions. The search strategy will include six electronic databases (PubMed, Cochrane Library, CINAHL, Embase, Scopus and Web of Science) used to retrieve relevant titles and abstracts based on a database-specific search strategy. Titles and abstracts will be independently screened by two reviewers, followed by a full-text eligibility assessment. Reviewers will also extract data based on this review’s objectives and outcomes. Analysis will be performed in three phases: descriptive analysis, evaluation of the evidence-based character of interventions and quantitative synthesis analysis.
Ethics approval is not needed. Dissemination will be performed through publication in peer-reviewed journals, conference presentations and informing policies and stakeholders by offering a structured overview of maternal care bundles on labour and childbirth.
PROSPERO 2025 CRD420251081127.
by Xuanqi Pan, Katerina Togka, Hilde ten Berge, Lisa de Jong, Harry Groen, Maarten J. Postma, Eleftherios Zervas, Ioannis Gkiozos, Christoforos Foroulis, Kyriaki Tavernaraki, Sofia Lampaki, Georgia Kourlaba, Antonios Moraris, Sofia Agelaki, Konstantinos Syrigos
ObjectiveThis study aimed to assess the cost-effectiveness of lung cancer screening (LCS) employing volume-based low-dose computed tomography (LDCT) in contrast to the absence of screening, targeting an asymptomatic high-risk population in Greece, leveraging the outcomes derived from the NELSON study, the largest European randomized control trial dedicated to LCS.
MethodsA validated model incorporating a decision tree and an integrated state-transition Markov model was used to simulate the identification, diagnosis, and treatments for a population at high risk of developing lung cancer, from a healthcare payer perspective. Screen-detected lung cancers, costs, life years (LYs), quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) were predicted. Sensitivity and scenario analyses were conducted to assess the robustness and reliability of the model’s outcomes under varying parameters and hypothetical situations.
ResultsAnnual LCS with volume-based LDCT detected 17,104 more lung cancer patients at early-stage among 207,885 screening population, leading to 8,761 premature lung cancer deaths averted. In addition, in contrast to no screening, LCS yielded 86,207 LYs gained and 50,207 incremental QALYs at an additional cost of €278,971,940, resulting in an ICER of €3,236 per LY and €5,505 per QALY, over a lifetime horizon. These estimates were robust in sensitivity analyses.
ConclusionsLCS with volume-based LDCT, targeting an asymptomatic high-risk population, is highly cost-effective in Greece. Implementing LCS ensures efficient allocation of public healthcare resources while delivering substantial clinical benefits to lung cancer patients.
FreshRSS 