A comparison of Australian and UK obstetricians' and midwives' preferences for screening tests for Down syndrome.
OBJECTIVE
To establish and compare obstetricians' and midwives' preferences for hypothetical prenatal screening tests for Down syndrome.


METHODS
A cross-sectional questionnaire survey was completed by 296 obstetricians and midwives at two teaching hospitals: one in Melbourne, Australia (n = 175), and one in London, UK (n = 94). Conjoint analysis was undertaken using random effects probit regression.


RESULTS
No significant differences were seen in any measurements when comparing obstetricians in Australia and the UK or midwives in Australia and the UK. Obstetricians and midwives shared similar relative values regarding the importance of the detection rate of the screening tests. However, obstetricians placed higher relative values on both timing of prenatal tests and risk associated with the subsequent diagnostic test than did midwives when considering optimal tests to offer women. Marginal rates of substitution suggest that, compared with midwives, obstetricians would wait longer and accept a greater decrease in detection rate for a test if it was safer. Younger midwives placed higher value on both detection rate and safety of prenatal tests than older midwives. Female obstetricians placed higher value on the timing of a test than male obstetricians.


CONCLUSIONS
Obstetricians in Australia and UK placed almost identical importance on test attributes, as did the midwives in the two countries. However, different attitudes towards tests were seen between obstetricians and midwives.
Lewis
Sharon M
SM
Public Health Genetics Unit, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, VIC 3052, Australia. sharon.lewis@mcri.edu.au
Cullinane
Fiona N
FN
Bishop
Amanda J
AJ
Chitty
Lyn S
LS
Marteau
Theresa M
TM
Halliday
Jane L
JL
D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D003430:Cross-Sectional Studies; D004314:Down Syndrome / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008880:Midwifery; D009774:Obstetrics; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom