妊娠年龄与产前检测中流产风险之间的权衡:它是否根据遗传风险而有所不同?
1Department of Obstetrics and Gynaecology, University of Leeds, St James's University Hospital, UK.
Lancet (London, England)
|November 24, 1990
概括
早些时候,风险较高的基因测试更容易被接受,基因风险更高. 一个决策树模型表明,较早,更容易流产的测试的实用性与较高的遗传风险 (每4分之一) 相比,与较低风险 (每100分之一) 相比,增加了更高的遗传风险 (每4分之一).
科学领域:
- 医学诊断 医学诊断 医学诊断
- 遗传学 遗传学 是一个
- 决策分析 决策分析
背景情况:
- 诊断性遗传测试对于评估胎儿健康至关重要.
- 早些时候的基因测试可能涉及更高的与程序相关的流产风险.
- 这些风险的可接受性通常被认为随着遗传风险的增加而增加.
研究的目的:
- 评估这样的假设,即更高的遗传风险增加了更早,更容易流产的诊断测试的可接受性.
- 在不同的遗传风险场景下,比较较早,风险较高的测试相对于较晚,风险较低的测试的相对可取性.
主要方法:
- 采用决策树模型来分析结果.
- 两种假设的诊断测试,A (早期,更高的流产风险) 和B (后期,更低的流产风险) 进行了比较.
- 结果包括与程序相关的正常胎儿流产,以及早期或晚期终止妊娠.
主要成果:
- 预期的效用,代表相对的可取性,被计算为不同的结果排名.
- 早期的,虽然更有风险的测试 (A测试) 在高遗传风险水平 (1/4),与低遗传风险水平 (1/100) 相比,显示出更大的实用性.
- 这一发现在广泛的结果排名中是正确的.
结论:
- 这项研究支持这样一个假设:较早,更有风险的基因诊断测试的可接受性随着基因风险的更高水平而增加.
- 关于产前遗传测试的时间和风险的决策应该考虑基线遗传风险.
- 这些发现对产前遗传查咨询和测试选择有影响.
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