Women's preferences in screening for Down syndrome.
OBJECTIVE
In this article, we seek to establish women's preferences (expressed as utility values) for a number of scenarios relating to the process and associated outcomes of first- and second-trimester screening for Down syndrome.


METHODS
We used the standard gamble (SG) approach with a sample of 100 pregnant women. Standard gamble is a choice-based preference elicitation technique that values scenarios on a 0-1 scale.


RESULTS
A true negative screening test, whether obtained in the first or second trimester, had the highest utility scores (both 0.98), which were not significantly different from the scores for the false-positive scenarios leading to first- or second-trimester invasive testing but the birth of a healthy infant (0.95 and 0.94, respectively). The mean utility score for the false-negative scenario resulting in the birth of a Down syndrome infant (0.77) was lower than both the true negative scenarios and the false-positive healthy baby scenarios (p < 0.000).


CONCLUSIONS
We did not find any differences in the values of the key scenarios regarding either the timing of reassurance of a healthy fetus or the ability to access early surgical termination, rather than later medical termination for a Down syndrome fetus.
Deverill
Mark
M
Centre for Health Services Research, School of Population and Health Sciences University of Newcastle, Newcastle upon Tyne, England, UK. mark.deverill@ncl.ac.uk
Robson
Stephen
S
D000328:Adult; D000649:Amniocentesis; D001294:Attitude to Health; D002755:Choice Behavior; D004314:Down Syndrome / Q000175:diagnosis*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D048208:Nuchal Translucency Measurement; D017060:Patient Satisfaction; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*