Amiram Gafni

The Control of Hypertension In Pregnancy Study pilot trial

Objectiveu2002 To determine whether ‘less tight’ (versus ‘tight’) control of nonsevere hypertension results in a difference in diastolic blood pressure (dBP) between groups.

Hospital selection for unit cost estimates in multicentre economic evaluations. Does the choice of hospitals make a difference

AbstractObjective: The objectives of this study were (i) to develop a conceptual framework for selecting hospitals for unit cost estimates in national and international multicentre trials and (ii) to test the impact of alternative hospital selection on the cost results.n Design and setting: Within the conceptual framework, the following considerations which can be used when selecting a sample of hospitals for unit cost estimates in multicentre trials were identified: the number of hospitals; the sampling method; and the desired level of geographical subanalysis. Results from a recently completed international multicentre trial were used to explore changes in cost results obtained by using alternativemethods of selecting and stratifying hospitals for unit cost estimates.n Patients and participants: The study included 5041 women from 72 hospitals in 6 countries with prelabour rupture of the membranes at term.n Interventions: The women were randomly assigned to induction of labour with intravenous oxytocin, induction of labour with prostaglandin E2 gel, or expectant management for up to 4 days with labour induced if complications developed.n Main outcome measures and results: Across each of the 4 management strategies of the study, the method of selecting and stratifying hospitals resulted in a 30 to 55% difference between the lowest and highest median unit cost estimates. In some cases, the relative ranking of the least to most expensive strategy varied across methods of hospital selection. The statistical comparisons across strategies found that the method used had a substantial impact on the conclusions of the economic evaluation.n Conclusions: Unit cost information should be collected from as many hospitals as possible. Multivariate hospital cost studies are needed to identify important cost drivers that will assist with hospital selection in the future.

The Cost Implications of Less Tight Versus Tight Control of Hypertension in Pregnancy (CHIPS Trial)

The CHIPS randomized controlled trial (Control of Hypertension in Pregnancy Study) found no difference in the primary perinatal or secondary maternal outcomes between planned “less tight” (target diastolic 100 mmu2009Hg) and “tight” (target diastolic 85 mmu2009Hg) blood pressure management strategies among women with chronic or gestational hypertension. This study examined which of these management strategies is more or less costly from a third-party payer perspective. A total of 981 women with singleton pregnancies and nonsevere, nonproteinuric chronic or gestational hypertension were randomized at 14 to 33 weeks to less tight or tight control. Resources used were collected from 94 centers in 15 countries and costed as if the trial took place in each of 3 Canadian provinces as a cost-sensitivity analysis. Eleven hospital ward and 24 health service costs were obtained from a similar trial and provincial government health insurance schedules of medical benefits. The mean total cost per woman–infant dyad was higher in less tight versus tight control, but the difference in mean total cost (DM) was not statistically significant in any province: Ontario (

The Early External Cephalic Version 2 Trial: An International Multicenter Randomized-controlled Trial of Timing of ECV for Breech Pregnancies

30u2009191.62 versus

Control of hypertension in pregnancy and small for gestational age infants (CHIPS): A randomised controlled trial of a diastolic bp (DBP) of 100 vs. 85 MMHG for mild-moderate pre-existing hypertension or non-proteinuric gestational hypertension

24u2009469.06; DM

Do Labetalol and Methyldopa Have Different Effects on Pregnancy Outcome? Analysis of Data From the Control of Hypertension In Pregnancy Study (CHIPS) Trial

5723, 95% confidence interval, −

The Control of Hypertension In Pregnancy Study (CHIPS) randomized controlled trial – is severe hypertension just an elevated blood pressure?

296 to

A Randomized Trial of Planned Cesarean or Vaginal Delivery for Twin Pregnancy

12u2009272; P=0.0725); British Columbia (

Effect of Antenatal Corticosteroids on Fetal Growth and Gestational Age at Birth

30u2009593.69 versus

7: The Twin Birth Study: a multicenter RCT of planned cesarean section (CS) and planned vaginal birth (VB) for twin pregnancies 320 to 386/7 weeks

24u2009776.51; DM