A tradeoff analysis of risk cutoffs for the quadruple serum screen for Down syndrome

作者：Walker Brandon^*; Ashwood Edward R; Jackson Brian R; Lagrave Danielle

来源：Prenatal Diagnosis, 2013, 33(12): 1201-1206.

DOI：10.1002/pd.4225

ObjectivesIn maternal serum screening for Down syndrome, a cutoff of 1:270 is often used as a decision point to recommend invasive confirmatory testing. However, it has not been established how well this or any other cutoff relates to patient preferences, that is, the values that pregnant women attach to various screening outcomes. The purpose of this study was to examine the clinical and economic tradeoffs of a wide range of risk cutoffs for the quadruple screen.
MethodsScreening costs and outcomes for multiple risk cutoffs were modeled using a Monte Carlo simulation.
ResultsThe optimal cutoff for maternal serum screening depends on the relative values placed by the patient on different outcomes. Total societal costs were similar across the range of cutoffs.
ConclusionsGiven that different screening outcomes are optimized by different cutoff values, a one-size-fits-all approach may not be appropriate.

• 出版日期2013-12