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Repeated measures screening for Down's Syndrome.

David E Wright1, Ian Bradbury

  • 1School of Mathematics and Statistics, University of Plymouth, UK.

BJOG : an International Journal of Obstetrics and Gynaecology
|January 25, 2005
PubMed
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Screening for Down's Syndrome using repeated serum markers in early pregnancy significantly reduces false positives. This approach offers an 85% detection rate with a 0.3% false positive rate, improving upon existing methods.

Area of Science:

  • Maternal-Fetal Medicine
  • Prenatal Diagnostics
  • Biochemical Screening

Background:

  • Down's Syndrome screening is crucial for prenatal care.
  • Current screening methods have limitations in detection rates and false positives.
  • Utilizing serum markers across multiple trimesters may enhance accuracy.

Purpose of the Study:

  • To evaluate the efficacy of using repeated serum markers for Down's Syndrome screening.
  • To compare the performance of a novel screening strategy with existing methods.
  • To demonstrate the potential value of first and second-trimester serum marker screening.

Main Methods:

  • A Monte Carlo simulation study was conducted.
  • Utilized marker distributions from the SURUSS study.

Related Experiment Videos

  • Incorporated maternal age distribution data from England and Wales (1996-1998).

    • Main Results:

    • Screening with first-trimester nuchal translucency and repeated uE3/PAPP-A markers achieved an 85% detection rate with a 0.3% false positive rate.
    • This performance surpasses the integrated test, which had a 1.2% false positive rate for the same detection rate.
    • Demonstrated a significant reduction in false positives compared to the integrated test.

    Conclusions:

    • Repeated measures screening demonstrates improved performance for Down's Syndrome detection.
    • The novel screening approach shows potential for lower false positive rates.
    • Further prospective studies are recommended to assess the performance and acceptability of these repeated measures screening tests.