Preferences regarding contemporary prenatal genetic tests among women desiring testing: implications for optimal testing strategies.

View Abstract

OBJECTIVES

To compare utilities for prenatal testing outcomes among women inclined to continue their pregnancy despite abnormal results versus those inclined to terminate and to analyze how differences affect optimal prenatal testing strategies.

METHOD

Time tradeoff utilities for 23 outcomes were elicited from 281 women. We compared utilities based on termination inclination and applied them to a decision-analytic framework.

RESULTS

Of participants, 46.6% indicated that they would 'definitely' or 'probably' continue their pregnancy despite results indicating an intellectual disability. These women assigned higher utilities to abnormal testing results and having a child with an intellectual disability than women who would probably or definitely terminate. Primary cell-free DNA screening had the most quality-adjusted life years for women inclined to continue their pregnancy but yielded an incremental cost-effectiveness ratio (ICER) of $1 685 449. Multiple marker screening with either cell-free DNA or diagnostic testing as follow-up had an ICER of $9037. Primary diagnostic testing resulted in the most quality-adjusted life years for women inclined to terminate, with an ICER of $111 776.

CONCLUSION

Women seeking testing vary in prenatal testing outcome preferences and termination inclinations in the context of results indicating an intellectual disability. How they envision utilizing prenatal testing information impacts their optimal testing strategy. © 2016 John Wiley & Sons, Ltd.

Investigators
Abbreviation
Prenat. Diagn.
Publication Date
2016-03-31
Volume
36
Issue
5
Page Numbers
469-75
Pubmed ID
26946227
Medium
Print-Electronic
Full Title
Preferences regarding contemporary prenatal genetic tests among women desiring testing: implications for optimal testing strategies.
Authors
Kuppermann M, Norton ME, Thao K, O'Leary A, Nseyo O, Cortez A, Kaimal AJ