Cost and cost-effectiveness analysis of point-of-care ultrasound (POCUS) in obstetrics: a systematic review protocol.

Introduction: Facing the profound health impacts and economic challenges posed by the high maternal mortality ratio worldwide, point-of-care ultrasound (POCUS) has shown its potential to enhance diagnostic efficiency, reduce healthcare costs and improve health outcomes. However, concerns regarding the explicit and implicit costs as well as actual clinical outcomes of POCUS also exist. This systematic review protocol aims to synthesise existing evidence regarding the costs and cost-effectiveness of POCUS in obstetric care to provide a clearer understanding of its economic and clinical impact, ultimately guaranteeing global maternal and neonatal health and supporting the vision of the 2030 sustainable development goals.

Methods And Analysis: This systematic review has been registered in Prospective Register of Systematic Reviews (PROSPERO; CRD42024572715) and follows the Joanna Briggs Institute Manual for Evidence Synthesis and Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. A comprehensive search was conducted across eight international and Chinese databases, as well as five specialised health economics retrieval databases. Eligible studies include formal economic evaluations and cost-related analyses of POCUS in obstetrics, selected using the 'Participants, Intervention, Comparison, Outcome and Study Design framework. The quality of included studies will be assessed using the Consensus Health Economic Criteria list, while data extraction will follow a standardised form based on the National Health Service Economic Evaluation Database Handbook. Narrative synthesis will be applied to summarise economic and clinical data, and, where appropriate, meta-analysis will be conducted for clinical outcomes. Heterogeneity will be assessed using Cochran's Q test and Higgins' I² statistic, and subgroup and meta-regression analyses will be used to explore the effect modification. All analyses will be conducted using Stata V.18.0, and a two-tailed p value of less than 0.05 will be considered statistically significant.

Ethics And Dissemination: Since this systematic review will exclusively use published and publicly available data, ethical approval is not required. The findings from this study will be published in peer-reviewed journals or presented at academic conferences.

Prospero Registration Number: CRD42024572715.