The Optimal Risk Cutoff Values for down Syndrome Screening Considering Women's Preferences
نویسندگان
چکیده
Prenatal screening for Down syndrome (DS) based on biomarker levels provides expectant parents with an estimated risk of a DS baby. The risk cutoff value of a prenatal screening test determines the detection and false positive rates and the selection of follow-up procedures, such as an invasive diagnostic test. Women who consider prenatal screening might face two undesirable outcomes: undetected DS live births (DSL) and procedure-related fetal losses (EFL). One-size-fits-all risk cutoff values, such as 1/270, are commonly used in DS screening to recommend diagnostic tests. However, evidence suggests that different women have different preferences about the pregnancy outcomes. The objective of this study is to find the optimal risk cutoff values for DS screening. As no closed-form solutions exist, we use Monte Carlo simulation to solve the proposed model. We find that age-specific risk cutoff values outperform one-size-fits-all risk cutoff values.
منابع مشابه
Risk preferences: consequences for test and treatment thresholds and optimal cutoffs.
Risk attitudes include risk aversion as well as higher-order risk preferences such as prudence and temperance. This article analyzes the effects of such preferences on medical test and treatment decisions, represented either by test and treatment thresholds or-when the test result is not given-by optimal cutoff values for diagnostic tests. For a risk-averse decision maker, effective treatment i...
متن کاملRELATIONSHIP BETWEEN THE SERUM LEVELS OF FOLIC ACID WITH THE RESULTS OF FIRST TRIMESTER DOWN SYNDROME SCREENING METHODS AND FETAL KARYOTYPE IN HIGH RISK PREGNANT WOMEN REFERRING TO THE ALZAHRA EDUCATIONAL HOSPITAL OF TABRIZ
Background & Aims: To investigate associations between serum levels of folic acid with the results of the first trimester Down syndrome screening methods and fetal karyotype in high-risk pregnant women. Materials & Methods: In this cross-sectional study, serum levels of folic acid in 232 high risk pregnant women were measured using ELISA method and Down syndrome screening was done using karyot...
متن کاملOptimal cutoff point of waist circumference and use of home blood pressure as a definition of metabolic syndrome: the Ohasama study.
BACKGROUND Self-measured blood pressure (BP) at home (HBP) has a stronger predictive power for cardiovascular mortality and morbidity than casual-screening BP (CBP). No studies have evaluated the clinical significance of self-measured HBP for diagnosing metabolic syndrome (MS). Eight scientific associations recently defined MS for the Japanese population. However, this definition remains contro...
متن کاملStatistical study of 45 false negative cases of Down syndrome in the first trimester screening protocol during 2015-2016 and introduction of a new criterion (Ratio> 3.0 of free BhCG MoM/PAPP-A MoM) to increase the efficacy of first trimester screenin
Introduction: Down syndrome screening has become an important part of antenatal care and is performed for pregnant women worldwide. In this study, 45 statistically accurate cases of false negatives in the first trimester screening tests have been examined statistically, so that by paying attention to some criteria, we can find out how many of these cases can be detected and how much each criter...
متن کاملHigher - Order Risk Preferences Consequences for Test and Treatment Thresholds and Optimal Cutoff s # 287
Higher-order risk attitudes include risk aversion, prudence, and temperance. This paper analyzes the eff ects of such preferences on medical test and treatment decisions, represented either by test and treatment thresholds or – if the test characteristics are endogenous – by the optimal cutoff value for testing. For a risk-averse decision maker, treatment is a risk reducing strategy since it pr...
متن کامل