Economic analysis of prenatal screening strategies for Down syndrome in singleton pregnancies in Turkey

Ökem, Zeynep Güldem; Örgül, Gökçen; Kasnakoğlu, Berna Tarı; Çakar, Mehmet Akif; Beksaç, Mehmet Sinan

doi:10.1016/j.ejogrb.2017.09.025

Cited by 15 publications

(22 citation statements)

References 24 publications

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“…PS is an essential component of antenatal care programs, and different types of tests are used for this purpose (11,12). Maternal blood biochemical markers and "maternal blood cell free fetal DNA" are still used in PS due to their cost-effectiveness (4,5). Classical statistical methods (probability algorithms) are used in DT, CT, and TT, which make patients uncomfortable in terms of understanding their purpose.…”

Section: Discussionmentioning

confidence: 99%

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An Intelligent Prenatal Screening System for the Prediction of Trisomy-21 Using Triple Test Variables: The Hacettepe System

Katlan¹,

Örgül

Leblebi̇ci̇oğlu

et al. 2019

Gynecol Obstet Reprod Med

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OBJECTIVE:To introduce an intelligent prenatal screening system, using triple test variables. STUDY DESIGN:In this study, we have used a backpropagation learning algorithm (a supervised artificial neural network) to develop an intelligent antenatal screening system (heretofore referred as Hacettepe System). Triple test variables were used as input variables, while "Down syndrome" and "non-Down syndrome" fetuses were the output of the algorithm. Unconjugated estriol (E3), beta-human chorionic gonadotropin, and α-feto protein with gestational week and maternal age (triple test) were used as input variables in the training and testing. Multiples of median values of the E3, α-feto protein, and betahuman chorionic gonadotropin were used in this study.The testing group of Hacettepe system consisted of 97 patients who were found to be high-risk (>1/250) during the routine antenatal screening (triple test) and underwent amniocentesis for fetal karyotyping. RESULTS:Amniocentesis was performed in 97 pregnancies with "high-risk" triple test results (>1/250). Fetal karyotyping revealed trisomy 21 in about 9.3% (9/97) of the pregnancies. Our algorithm (Hacettepe System) detected 77.8% (7/9) of Down syndrome cases. Moreover, all of the normal fetal karyotypes were assigned as normal in the Hacettepe System. CONCLUSION:We have developed an intelligent system using the backpropagation learning algorithm (using triple test variables) to predict trisomy 21.

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Section: Discussionmentioning

confidence: 99%

“…Some institutions are still using PS tests based on maternal serum biochemical markers because of their cost-effectiveness (4,5). Different probability algorithms (such as the tri-variate Gaussian algorithm) with various cut-off values are used in routine clinical practice (6).…”

mentioning

confidence: 99%

An Intelligent Prenatal Screening System for the Prediction of Trisomy-21 Using Triple Test Variables: The Hacettepe System

Katlan¹,

Örgül

Leblebi̇ci̇oğlu

et al. 2019

Gynecol Obstet Reprod Med

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show abstract

“…In addition, NIPT also has minimal risks of fetal losses compared to invasive procedures. It is estimated that the implementation of NIPT as a second step screening procedure in high-risk pregnancies would lead to a 10.2% increase in detected Down syndrome cases and a 96.3% decrease in fetal losses (14). However, NIPT needs to be implemented in combination with other prenatal tests to avoid certain limitations.…”

Section: Discussionmentioning

confidence: 99%

Detection of chromosome abnormalities using current noninvasive prenatal testing: A multi-center comparative study

Lin

Lan

et al. 2018

BST

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“…Bu amaçla maternal kanda human koriyonik gonadotropin (HCG)'nin serbest beta alt birimi (β-hCG ) ve gebelik ile ilişkili plazma protein A (PAPP-A) düzeyleri belirlenerek bazı değişkenlerin de eklenmesi ile kişiye özgü bir risk hesaplanmaktadır (1). Kombine test ile prenatal dönemde Down Sendromu'nu yakalama oranı yaklaşık %90 olup yanlış pozitiflik oranı %5 civarındadır (2).…”

Section: Introductionunclassified

İlk Trimester Tarama Test Biyobelirteçlerinin Gestasyonel Diyabetes Mellitus İle İlişkisi

Örgül

Ayik

Şahın

et al. 2020

Turkish Journal of Diabetes and Obesity

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Aim: Pregnancy-related plasma protein A (PAPP-A) and human chorionic gonadotropin free beta subunit (β-hCG) are used as biochemical markers in first trimester Down Syndrome screening. The relationship between gestational diabetes mellitus (GDM) and combined test results was investigated in this study. Material and Methods:The study group consisted of 95 patients who were diagnosed as GDM and gave birth at our hospital between 1 August 2018 and 31 October 2018. The control group consisted of 100 patients who were delivered at term in our hospital, had no additional disease or pregnancy complications with combined test results. First trimester serum β-hCG and PAPP-A levels of the patients were compared.Results: PAPP-A level and MoM value and β-hCG level and MoM value were lower in GDM group. (p value 0.013; 0.081; 0.001 and 0.007). The optimum cut-off value was 1.715 ng/mL (sensitivity 61%, specificity 22%) for PAPP-A and 0.905 (sensitivity 51.6%, specificity 39%) for PAPP-A MoM. The ideal cut-off value was 25.75 mIU/mL (sensitivity 56.8%, specificity 30%) for β-hCG and 0.745 (sensitivity 57.9%, specificity 28%) for β-hCG MoM. Conclusion:PAPP-A and β-hCG levels were lower in GDM than healthy pregnant women. However, false positive rates for both PAPP-A and β-hCG are quite high.

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Economic analysis of prenatal screening strategies for Down syndrome in singleton pregnancies in Turkey

Cited by 15 publications

References 24 publications

An Intelligent Prenatal Screening System for the Prediction of Trisomy-21 Using Triple Test Variables: The Hacettepe System

An Intelligent Prenatal Screening System for the Prediction of Trisomy-21 Using Triple Test Variables: The Hacettepe System

Detection of chromosome abnormalities using current noninvasive prenatal testing: A multi-center comparative study

İlk Trimester Tarama Test Biyobelirteçlerinin Gestasyonel Diyabetes Mellitus İle İlişkisi

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