Integrating antenatal Down's syndrome screening

Current Opinion in Obstetrics & Gynecology
H S Cuckle

Abstract

Statistical modelling is used to predict screening detection and false-positive rates for policies using different marker combinations and screening modalities. Parameters are derived wherever possible from meta-analyses. Screening with four serum markers yields a similar detection rate in the first trimester as it does in the second, and both have a similar detection rate to that of ultrasound nuchal translucency screening. Ultrasound anomaly screening has a low detection rate. The integration of the different screening modalities can yield very high detection rates. Some methods of integration are preferable to others. The concurrent use of first trimester serum markers and ultrasound nuchal translucency is the most practical. The combination of three modalities with nondisclosure of the intermediate results is more efficient, but the gain in detection is too small to warrant the wait for up to 4 weeks for results. The sequential use of modalities with intermediate disclosure is more practical but will generate higher false-positive rates.

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Citations

Sep 3, 2002·Clinica Chimica Acta; International Journal of Clinical Chemistry·Peter A Benn
Apr 16, 2002·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·H S Cuckle
Nov 9, 2002·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·A HermanS Tercanli
Mar 27, 2002·Current Opinion in Obstetrics & Gynecology·Peter MinyWolfgang Holzgreve
Sep 2, 2004·Gynecologic and Obstetric Investigation·Wilfried J A GyselaersJan G Nijhuis
Oct 16, 2007·Fetal Diagnosis and Therapy·Olivier PiconeRene Frydman
Feb 9, 2008·Medicinski pregled·Aleksandra Novakov-Mikić
Nov 20, 2004·Obstetrics and Gynecology Clinics of North America·Ray O Bahado-Singh, Jaime Sutton-Riley
Jun 23, 2005·American Journal of Obstetrics and Gynecology·Kyriaki AvgidouKypros H Nicolaides
Feb 22, 2002·Prenatal Diagnosis·H S CuckleR G Jones
Apr 22, 2003·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·K H Nicolaides
Aug 9, 2003·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·M V SenatY Ville
Jun 2, 2004·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·R MaymonA Herman
Jul 6, 2006·Prenatal Diagnosis·Nicholas J WaldJonathan P Bestwick
Feb 1, 2008·Prenatal Diagnosis·Howard S CuckleMary E D'Alton
Apr 22, 2005·BJOG : an International Journal of Obstetrics and Gynaecology·Mandy G Katz-JaffeDavid S Cram
Nov 23, 2005·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·R MaymonA Herman
Sep 26, 2012·Prenatal Diagnosis·Paolo Guanciali-FranchiPeter Benn
Mar 14, 2003·Current Opinion in Obstetrics & Gynecology·Csaba Papp, Zoltán Papp
Aug 3, 2004·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·M A MüllerC M Bilardo

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