Gilbert, RE; Augood, C; Gupta, R; Ades, AE; Logan, S; Sculpher, M; van Der Meulen, JH; (2001) Screening for Down's syndrome: effects, safety, and cost effectiveness of first and second trimester strategies. BMJ (Clinical research ed), 323 (7310). pp. 423-425. ISSN 0959-8138 DOI: https://doi.org/10.1136/bmj.323.7310.423
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
Abstract
OBJECTIVE: To compare the effects, safety, and cost effectiveness of antenatal screening strategies for Down's syndrome. DESIGN: Analysis of incremental cost effectiveness. SETTING: United Kingdom. MAIN OUTCOME MEASURES: Number of liveborn babies with Down's syndrome, miscarriages due to chorionic villus sampling or amniocentesis, health care costs of screening programme, and additional costs and additional miscarriages per additional affected live birth prevented by adopting a more effective strategy. RESULTS: Compared with no screening, the additional cost per additional liveborn baby with Down's syndrome prevented was 22 000 pound sterling for measurement of nuchal translucency. The cost of the integrated test was 51 000 pound sterling compared with measurement of nuchal translucency. All other strategies were more costly and less effective, or cost more per additional affected baby prevented. Depending on the cost of the screening test, the first trimester combined test and the quadruple test would also be cost effective options. CONCLUSIONS: The choice of screening strategy should be between the integrated test, first trimester combined test, quadruple test, or nuchal translucency measurement depending on how much service providers are willing to pay, the total budget available, and values on safety. Screening based on maternal age, the second trimester double test, and the first trimester serum test was less effective, less safe, and more costly than these four options.
Item Type | Article |
---|---|
Keywords | Nuchal translucency measurement, maternal age, women, amniocentesis, multicenter, preferences, thickness, gestation, fetuses, uk, Abortion, Spontaneous, etiology, Amniocentesis, adverse effects, economics, Chorionic Villi Sampling, adverse effects, economics, Comparative Study, Cost-Benefit Analysis, Down Syndrome, diagnosis, Female, Fetal Diseases, diagnosis, Human, Infant, Newborn, Mass Screening, economics, methods, Maternal Age, Pregnancy, Pregnancy Trimester, First, Pregnancy Trimester, Second, Prenatal Diagnosis, adverse effects, economics, methods, Support, Non-U.S. Gov't, Treatment Outcome |
Faculty and Department | Faculty of Public Health and Policy > Dept of Health Services Research and Policy |
PubMed ID | 11520837 |
ISI | 170793600018 |
Related URLs |