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Age-based differences in the predictive accuracy of a one-size-fits-all risk-cutoff value in prenatal integrated
Jia Yan1, Turgay Ayer1, Pinar Keskinocak1
1H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
Objective:
The objective of this study is to assess variation in detection and false positive rates and adverse pregnancy outcomes across different age groups when a one-size-fits-all risk-cutoff value, such as 1/270, is used in integrated screening for Down syndrome.
Method:
A Monte Carlo simulation was utilized to estimate the detection and false positive rates as well as adverse pregnancy outcomes.
Results:
Using a one-size-fits-all risk-cutoff value, such as 1/270, can result in considerably high variations in detection and false positive rates across maternal ages and lead to a higher than the minimum possible total number of adverse outcomes.
Conclusion:
Our findings indicate that the one-size-fits-all risk-cutoff value of 1/270, commonly used in DS screening, should be revisited and alternative (possibly age-based) cutoff values and strategies should be considered. © 2017 John Wiley & Sons, Ltd.
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