Clinical and Economic Evaluation after Adopting Contingent Cell-Free DNA Screening for Fetal Trisomies in South Spain
| Autor: | Manuel Vargas, María R Torres, M. M. Gil, José Antonio Sainz, Pilar Carrasco, Belén Santacruz, Ignacio Peral, José Antonio García-Mejido, Reyes Granell |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Embryology
medicine.medical_specialty Fetus Obstetrics business.industry Prenatal diagnosis Obstetrics and Gynecology General Medicine medicine.disease University hospital First trimester screening Fetal trisomy Cell-free DNA Cell-free fetal DNA Pediatrics Perinatology and Child Health Economic evaluation medicine Combined test Radiology Nuclear Medicine and imaging Contingent screening Trisomy business Prospective cohort study |
| Zdroj: | DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria instname DDFV: Repositorio Institucional de la Universidad Francisco de Vitoria Universidad Francisco de Vitoria |
| Popis: | Introduction: Contingent cell-free (cf) DNA screening on the basis of the first-trimester combined test (FCT) results has emerged as a cost-effective strategy for screening of trisomy 21 (T21). Objectives: To assess performance, patients’ uptake, and cost of contingent cfDNA screening and to compare them with those of the established FCT. Methods: This is a prospective cohort study including all singleton pregnancies attending to their FCT for screening of T21 at 2 university hospitals in South Spain. When the FCT risk was ≥1:50, there were major fetal malformations, or the nuchal translucency was ≥3.5 mm, women were recommended invasive testing (IT); if the risk was between 1:50 and 1:270, women were recommended cfDNA testing; and for risks bellow 1:270, no further testing was recommended. Detection rate (DR), false-positive rate (FPR), patients’ uptake, and associated costs were evaluated. Results: We analyzed 10,541 women, including 46 T21 cases. DR of our contingent strategy was 89.1% (41/46) at 1.4% (146/10,541) FPR. Uptake of cfDNA testing was 91.2% (340/373), and overall IT rate was 2.0%. The total cost of our strategy was €1,462,895.7, similar to €1,446,525.7 had cfDNA testing not been available. Conclusions: Contingent cfDNA screening shows high DR, low IT rate, and high uptake at a similar cost than traditional screening. |
| Databáze: | OpenAIRE |
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