OBJECTIVES: To map prenatal screening and diagnostic testing pathways in Victorian pregnant women during 2003 to 2004; measure the impact of prenatal diagnostic testing uptake on the effectiveness of prenatal screening for Down syndrome; and assess factors influencing uptake of diagnostic testing following screening. METHODS: State-wide data collections of prenatal screening and diagnostic tests were linked to all Victorian births and pregnancy terminations for birth defects. RESULTS: Overall, 52% of women had a prenatal test (65 692/126 305); screening (44.9%), diagnostic testing (3.9%), or both (3.2%). Uptake of diagnostic testing was 71.4% (2390/3349) after an increased risk screen result, and 2.5% (1381/54 286) after a low risk result. Variation in uptake of diagnostic testing reduced the effectiveness of the screening program by 11.2%: from 87.4% (sensitivity - 125/143) to 76.2% (prenatal diagnoses of Down syndrome - 109/143). In both the increased and low risk groups, uptake was influenced by absolute numerical risk, as well as by the change in numerical risk from a priori risk. CONCLUSIONS: This comprehensive follow-up demonstrates clearly that numerical risk is being used to aid in decision making about confirmatory diagnostic testing. Collectively, these fundamental individual decisions will impact on the overall effectiveness of screening programmes for Down syndrome.
OBJECTIVES: To map prenatal screening and diagnostic testing pathways in Victorian pregnant women during 2003 to 2004; measure the impact of prenatal diagnostic testing uptake on the effectiveness of prenatal screening for Down syndrome; and assess factors influencing uptake of diagnostic testing following screening. METHODS: State-wide data collections of prenatal screening and diagnostic tests were linked to all Victorian births and pregnancy terminations for birth defects. RESULTS: Overall, 52% of women had a prenatal test (65 692/126 305); screening (44.9%), diagnostic testing (3.9%), or both (3.2%). Uptake of diagnostic testing was 71.4% (2390/3349) after an increased risk screen result, and 2.5% (1381/54 286) after a low risk result. Variation in uptake of diagnostic testing reduced the effectiveness of the screening program by 11.2%: from 87.4% (sensitivity - 125/143) to 76.2% (prenatal diagnoses of Down syndrome - 109/143). In both the increased and low risk groups, uptake was influenced by absolute numerical risk, as well as by the change in numerical risk from a priori risk. CONCLUSIONS: This comprehensive follow-up demonstrates clearly that numerical risk is being used to aid in decision making about confirmatory diagnostic testing. Collectively, these fundamental individual decisions will impact on the overall effectiveness of screening programmes for Down syndrome.
Authors: S Kate Alldred; Yemisi Takwoingi; Boliang Guo; Mary Pennant; Jonathan J Deeks; James P Neilson; Zarko Alfirevic Journal: Cochrane Database Syst Rev Date: 2017-03-15
Authors: Miriam Kuppermann; Sherri Pena; Judith T Bishop; Sanae Nakagawa; Steven E Gregorich; Anita Sit; Juan Vargas; Aaron B Caughey; Susan Sykes; Lasha Pierce; Mary E Norton Journal: JAMA Date: 2014-09-24 Impact factor: 56.272
Authors: Katelijne Bouman; Marian K Bakker; Erwin Birnie; Lies Ter Beek; Caterina M Bilardo; Irene M van Langen; Hermien E K de Walle Journal: BMC Pregnancy Childbirth Date: 2017-01-05 Impact factor: 3.007
Authors: Dick Oepkes; G C Lieve Page-Christiaens; Caroline J Bax; Mireille N Bekker; Catia M Bilardo; Elles M J Boon; G Heleen Schuring-Blom; Audrey B C Coumans; Brigitte H Faas; Robert-Jan H Galjaard; Attie T Go; Lidewij Henneman; Merryn V E Macville; Eva Pajkrt; Ron F Suijkerbuijk; Karin Huijsdens-van Amsterdam; Diane Van Opstal; E J Joanne Verweij; Marjan M Weiss; Erik A Sistermans Journal: Prenat Diagn Date: 2016-11-15 Impact factor: 3.050