Patient or physician preferences for decision analysis: the prenatal genetic testing decision

Area of Science:

• Medical Decision Making
• Prenatal Genetic Testing

Background:

• Prenatal genetic testing involves choosing between amniocentesis and chorionic villus sampling, each with unique benefits and risks.
• Decision analysis offers a structured method for evaluating these tradeoffs.

Purpose of the Study:

• To investigate the relationship between patient and physician preferences and the selection of prenatal genetic tests.
• To compare decision-analytic models based on patient versus physician preferences in predicting test choice.

Main Methods:

• Patient and physician preferences were assessed using written scenarios and linear rating scales.
• Decision-analytic models were constructed based on these preferences.
• Statistical analysis, including logistic regression and kappa statistics, was used to evaluate associations and agreement.

Main Results:

• Test choices were significantly associated with decision models based on patient preferences (OR 4.44).
• No significant association was found between test choices and models based on physician preferences (OR 1.60).
• Agreement between patient and physician preference models was minimal (kappa = 0.085).

Conclusions:

• Patient preferences, when incorporated into decision models, accurately reflect the choice between amniocentesis and chorionic villus sampling.
• Physician preferences did not demonstrate a similar predictive power for patient test selection.
• Further prospective studies are needed to confirm these findings, as preferences were assessed post-referral.