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Performance of antenatal reflex DNA screening for Down's syndrome.
Performance of antenatal reflex DNA screening for Down's syndrome.
- Source :
-
Journal of medical screening [J Med Screen] 2015 Dec; Vol. 22 (4), pp. 168-74. Date of Electronic Publication: 2015 Apr 16. - Publication Year :
- 2015
-
Abstract
- Objective: Maternal plasma DNA analysis has a high but imperfect antenatal Down's syndrome screening performance. We aimed to determine the effect of combining DNA testing with current tests.<br />Methods: In our modelled screening protocol, women provide two samples, one serum sample for a Combined test, and a plasma sample for a possible DNA test. Women with a Combined test risk above a specified level have a DNA test using the plasma sample without the need to recall them for another sample and counselling (ie. in a reflex manner). Women with a failed DNA test after a second attempt using a fresh plasma sample have an Integrated test. Screening performance was estimated according to the proportion of women reflexed to DNA testing and compared with universal DNA testing.<br />Results: Reflexing 10% of women to a DNA test yields a 91% detection rate (DR) for a 0.025% false-positive rate (FPR) and no failed tests, compared with a 98% DR, 0.2% FPR and a 2.5% test failure rate with universal DNA testing (94% for 0.046% if 20% reflexed). DNA test failure rate has little influence on screening performance<br />Conclusion: Reflex DNA testing substantially reduces the FPR with a relatively small loss in detection compared with universal DNA testing, and reduces patient anxiety by avoiding the recall of women for DNA testing.<br /> (© The Author(s) 2015.)
- Subjects :
- Adult
Down Syndrome genetics
False Positive Reactions
Female
Humans
Maternal Serum Screening Tests methods
Maternal Serum Screening Tests standards
Multivariate Analysis
Pregnancy
Prenatal Diagnosis standards
Down Syndrome diagnosis
Prenatal Diagnosis methods
Sequence Analysis, DNA standards
Subjects
Details
- Language :
- English
- ISSN :
- 1475-5793
- Volume :
- 22
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of medical screening
- Publication Type :
- Academic Journal
- Accession number :
- 25882667
- Full Text :
- https://doi.org/10.1177/0969141315581005