Evaluating the benefits of antenatal screening: an alternative approach.

This paper presents an alternative method of valuing the benefits of antenatal screening programmes based on individual preferences. The methods of benefit measurement used to date, namely averted costs, QALYs, and willingness to pay, are critically reviewed. The alternative method assumes that screening can be regarded as an investment in improved information, and that the benefits of screening can be measured by the value placed upon this information. The information is valued by presenting individuals with standard gamble questions framed in terms of a prenatal diagnostic choice. The approach is developed in the context of antenatal screening for Down's syndrome and for cystic fibrosis carrier status. Some empirical testing of the approach is reported for the latter.