Trade-offs in prenatal detection of Down syndrome.
Am J Public Health
; 88(4): 551-7, 1998 Apr.
Article
en En
| MEDLINE
| ID: mdl-9550991
OBJECTIVES: This paper presents the results of different screening policies for prenatal detection of Down syndrome that would allow decision makers to make informed choices. METHODS: A decision analysis model was built to compare 8 screening policies with regard to a selected set of outcome measures. Probabilities used in the analysis were obtained from official administrative data reports in Spain and Catalonia and from data published in the medical literature. Sensitivity analyses were carried out to test the robustness of screening policies' results to changes in uptake rates, diagnostic accuracy, and resources consumed. RESULTS: Selected screening policies posed major trades-offs regarding detection rates, false-positive results, fetal loss, and costs of the programs. All outcome measures considered were found quite robust to changes in uptake rates. Sensitivity and specificity rates of screening tests were shown to be the most influential factors in the outcome measures considered. CONCLUSIONS: The disclosed trade-offs emphasize the need to comprehensively inform decision makers about both positive and negative consequences of adopting one screening policy or another.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Diagnóstico Prenatal
/
Árboles de Decisión
/
Tamizaje Masivo
/
Síndrome de Down
/
Medición de Riesgo
/
Selección de Paciente
/
Mujeres Embarazadas
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Límite:
Female
/
Humans
/
Pregnancy
País/Región como asunto:
Europa
Idioma:
En
Revista:
Am J Public Health
Año:
1998
Tipo del documento:
Article
País de afiliación:
España
Pais de publicación:
Estados Unidos