Women's and health professionals' preferences for prenatal testing for Down syndrome in Australia.
OBJECTIVE
To describe and compare women's and health professionals' preferences for prenatal screening tests for Down syndrome.


METHODS
Cross-sectional questionnaire survey.


METHODS
Women (n = 322) attending for a glucose challenge test at 26 weeks gestation and health professionals (266 midwives and 34 obstetricians) at the Royal Women's Hospital, Melbourne, between 13 December 2002 and 30 April 2003.


METHODS
The relative value participants attach to attributes of Down syndrome screening tests as determined by conjoint analysis and ranking scales.


RESULTS
Women and health professionals shared similar relative values regarding the importance of detection rate of screening tests, according to coefficients from conjoint analysis models. However, health professionals placed higher relative values on timing of prenatal tests and risk associated with the subsequent diagnostic test than did women. Comparison of coefficients suggests that, compared with health professionals, women would wait longer and accept a greater decrease in detection rate for a test if it was safer. Using the more traditional ranking scale, the safest test was ranked first by 56% of women while 47% of health professionals ranked a test with the highest detection rate first. Equal proportions ( approximately 10%) in both groups ranked the earliest test first.


CONCLUSIONS
There is a general agreement between pregnant women and health professionals regarding the relative importance they attach to different attributes of a test. However, health professionals appeared to favour earlier timing of tests while women placed greater emphasis on safety. Utilising two different measures of preference demonstrated the complexity of decision-making.
Lewis
Sharon M
SM
Public Health Genetics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia. sharon.lewis@mcri.edu.au
Cullinane
Fiona M
FM
Carlin
John B
JB
Halliday
Jane L
JL
D000293:Adolescent; D000328:Adult; D001290:Attitude; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003657:Decision Making; D004314:Down Syndrome / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008880:Midwifery; D017063:Outcome Assessment, Health Care; D010820:Physicians; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011295:Prenatal Care; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014739:Victoria