Women and health care professionals' preferences for Down's Syndrome screening tests: a conjoint analysis study

Ductus venosus blood flow, expressed as a pulsatility index (DVPI) has been shown to improve the performance of the Combined and Integrated antenatal screening tests for Down's syndrome using previously published data. The use of ductus venosus blood flow as a categorical marker (reversed or absent end diastolic blood flow indicating a positive result) is less discriminatory but simpler, so is sometimes preferred over DVPI. For example, with the Integrated test the false-positive rate for a 90% detection rate was 1.5% as a categorical marker compared with 1.1% expressed as DVPI. We here provide the necessary algorithm and parameters for using ductus venosus blood flow as a categorical marker with the Combined and Integrated tests.

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Two kinds of common prenatal screening tests for Down’s syndrome: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/srep18866 ◽

2016 ◽

Vol 6 (1) ◽

Cited By ~ 7

Author(s):

Yuan Yao ◽

Yang Liao ◽

Mei Han ◽

Sheng-Lan Li ◽

Juan Luo ◽

...

Keyword(s):

Systematic Review ◽

Prenatal Screening ◽

Meta Analysis ◽

Down's Syndrome ◽

Down’S Syndrome ◽

Screening Tests

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Health care costs for children with Down's syndrome “substantial”

PharmacoEconomics & Outcomes News ◽

10.2165/00151234-200805640-00014 ◽

2008 ◽

Vol 564 (1) ◽

pp. 6-6

Keyword(s):

Health Care ◽

Health Care Costs ◽

Down's Syndrome ◽

Down’S Syndrome ◽

Care Costs

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Evaluation of knowledge, attitudes, and screening practices about cancer risk factors among health care professionals

10.21203/rs.3.rs-21540/v1 ◽

2020 ◽

Author(s):

Zahra Sheikhalipour ◽

Akram Ghahramanian ◽

Zohreh Sanaat ◽

Leila Vahedi

Keyword(s):

Risk Factors ◽

Health Care ◽

Cancer Screening ◽

Cancer Risk ◽

Health Care Professionals ◽

Warning Signs ◽

Care Staff ◽

Screening Tests ◽

Cancer Risk Factors ◽

Cancer Screening Tests

Abstract Background: Given the importance of health care personnel’s awareness of cancer symptoms, this study aimed to investigate their knowledge regarding cancer warning symptoms, attitudes toward cancer risk factors, and performance on undertaking cancer screening tests.Methods: This was a cross-sectional study which 145 health care staff working in the medical centers affiliated with Tabriz University of Medical Sciences prticipated in it. The study population included nurses, midwives, operating room technicians, laboratory staff, anesthesiologists and radiologists. Items assessing awareness of cancer warning signs, risk factors, incidence, screening programmes were extracted from the literature.Results: The mean knowledge score of health care staffs was 7.97±2.01. Regarding the staff’s attitude toward the role of risk factors in increasing the likelihood of cancer, the results showed an average attitude score of 35.41±4.69. Concerning the performance of the participants in cancer screening tests, the results showed that out of 125 women aged 25-57 years, only 44% performed monthly self-examinations, 22.1% referred to a specialist physician for breast cancer screening every three years and only 20.51% of the female participants aged over 40 years old performed mammography. In terms of cervical cancer screening in female participants, 27.2% had performed annual Pap smear tests, and 17.6% referred to a specialist for annual pelvic examinations. Regarding colorectal cancer screening in staff older than 45 years, our findings showed that from 24 participants (16.6% of the samples), only one had undertaken occult blood test and performed colonoscopy.Conclusions: Because the public health depends on the wellness of health care professionals and their awareness of cancer warning signs, as well as their knowledge of cancer risk factors and adherence to cancer screening tests, they should be encouraged to perform these examinations.

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Atypicality or Specific Screen: Which is Better at Detecting Non-Down's Chromosomal Anomalies?

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/000456329703400613 ◽

1997 ◽

Vol 34 (6) ◽

pp. 675-680 ◽

Cited By ~ 2

Author(s):

T M Reynolds

Keyword(s):

Chromosomal Abnormalities ◽

Screening Program ◽

Down's Syndrome ◽

Down’S Syndrome ◽

Chromosome Abnormalities ◽

Trisomy 18 ◽

Trisomy 13 ◽

Screening Tests ◽

Chromosomal Anomalies ◽

Screening Programs

I evaluated the value of adding a trisomy 18 screen to routine Down's screening and compared it with the benefits of atypicality screening. I studied 5080 unaffected pregnancies, 144 Down's syndrome and 190 non-Down's syndrome chromosome abnormalities (20 trisomy 13; 79 trisomy 18; 20 Turner's syndrome; 29 other sex chromosome abnormalities; 8 triploidy; and 34 miscellaneous). Using a one in 250 cut off, the Down's screen gave a screen positive rate of 4·07%; addition of atypicality without a trisomy 18 screen gave an extra 0·9% screen positives; trisomy 18 screening without atypicality gave an extra 0·51% screen positives; and atypicality screening after trisomy 18 screening gave 0·52% screen positives. Total screen positive rates were: Down's screening only, 4·07%; Down's screening + atypicality, 4·97%; Down's screening + trisomy 18 screen, 4·58%; Down's screening + trisomy 18 screen + atypicality, 5·09%. The detection rate for Down's syndrome using a one in 250 cut off was 58·9% and with addition of trisomy 18 and atypicality screening this increased to 59·3%, indicating that the extra screens add little to detection of Down's syndrome. For the other chromosomal abnormalities, Down's screening alone detected 22·6% of cases overall and addition of trisomy 18 and atypicality screening increased this to 49%. Examination of the marginal benefits of the extra screening tests revealed that the trisomy 18 screen was better at detecting chromosomal abnormalities than the Down's screen and that it would, therefore, be worthwhile adding this to all screening programs. Atypicality proved to be much less effective and it is suggested that this screen should only be applied in the early days of a screening program until sufficient data is available to design specific screens.

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Screening for Down's Syndrome: The Effect of Test Date on the Detection Rate

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/000456329803500106 ◽

1998 ◽

Vol 35 (1) ◽

pp. 57-61 ◽

Cited By ~ 14

Author(s):

F D J Dunstan ◽

A B J Nix

Keyword(s):

Detection Rate ◽

Down's Syndrome ◽

Fetal Loss ◽

Down’S Syndrome ◽

Screening Tests ◽

Standard Errors ◽

Detection Rates ◽

Statistical Comparison ◽

True Detection

Screening tests for Down's syndrome are carried out at different gestational ages. Because of fetal loss, crude estimates of their detection rates cannot be directly compared. We present methods for estimating the true detection rates along with their standard errors. This enables a proper statistical comparison of the true detection rates of tests carried out, for example, in different trimesters.

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Fewer women aged 35 and older choose serum screening for Down’s syndrome: Impact and implications

Journal of Medical Screening ◽

10.1177/0969141318797961 ◽

2018 ◽

Vol 26 (2) ◽

pp. 59-66

Author(s):

Geralyn Lambert-Messerlian ◽

Glenn E Palomaki

Keyword(s):

Older Women ◽

False Positive ◽

Maternal Age ◽

Detection Rate ◽

Down's Syndrome ◽

Down’S Syndrome ◽

Screening Tests ◽

Integrated Testing ◽

Serum Screening ◽

The Impact

Objective To quantify changes in the proportion of women aged 35 and older choosing serum screening for Down’s syndrome over time and the effect on false positive and detection rates. Methods From Rhode Island hospital-based laboratory prenatal screening records (2013–2017) we extracted the test performed (Integrated, Combined, Quadruple), maternal age, and Down’s syndrome risk; documented observed changes in maternal age distributions and false positive rates, and modelled the impact of varying proportions of older women choosing screening on each test’s performance using the 2015 United States birth cohort as baseline. Results Over five years, observed false positive rates for Integrated testing declined from 1.9 to 1.3% (−32%). The proportion of older women tested declined from 14.9 to 8.5%, from which modelling predicts a 16% decline in the false positive rate. This is lower than our observed change but consistent with a reduction driven by declining participation by older women. Modelling predicted a detection rate reduction from 89 to 87%. Larger detection rate impacts were predicted for Combined and Quadruple testing. Conclusions This study documents, for the first time, the declining proportion of older women choosing Down’s syndrome serum screening and subsequent impact on screening performance. The American College of Obstetrics and Gynecology recommends offering cell-free DNA screening for these ‘high risk’ pregnancies and uptake may increase further. Screening programmes could consider increasing use of Integrated testing over other serum screening tests or lowering risk cut-offs so false positive rates approach those of 2012 to regain lost detection.

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