Lewis Sharon M, Cullinane Fiona N, Bishop Amanda J, Chitty Lyn S, Marteau Theresa M, Halliday Jane L
Public Health Genetics Unit, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, VIC 3052, Australia.
Prenat Diagn. 2006 Jan;26(1):60-6. doi: 10.1002/pd.1357.
To establish and compare obstetricians' and midwives' preferences for hypothetical prenatal screening tests for Down syndrome.
A cross-sectional questionnaire survey was completed by 296 obstetricians and midwives at two teaching hospitals: one in Melbourne, Australia (n = 175), and one in London, UK (n = 94). Conjoint analysis was undertaken using random effects probit regression.
No significant differences were seen in any measurements when comparing obstetricians in Australia and the UK or midwives in Australia and the UK. Obstetricians and midwives shared similar relative values regarding the importance of the detection rate of the screening tests. However, obstetricians placed higher relative values on both timing of prenatal tests and risk associated with the subsequent diagnostic test than did midwives when considering optimal tests to offer women. Marginal rates of substitution suggest that, compared with midwives, obstetricians would wait longer and accept a greater decrease in detection rate for a test if it was safer. Younger midwives placed higher value on both detection rate and safety of prenatal tests than older midwives. Female obstetricians placed higher value on the timing of a test than male obstetricians.
Obstetricians in Australia and UK placed almost identical importance on test attributes, as did the midwives in the two countries. However, different attitudes towards tests were seen between obstetricians and midwives.
建立并比较产科医生和助产士对唐氏综合征假设性产前筛查测试的偏好。
对澳大利亚墨尔本一家教学医院（n = 175）和英国伦敦一家教学医院（n = 94）的296名产科医生和助产士进行了横断面问卷调查。使用随机效应概率回归进行联合分析。
比较澳大利亚和英国的产科医生或澳大利亚和英国的助产士时，在任何测量指标上均未发现显著差异。产科医生和助产士在筛查测试检出率的重要性方面具有相似的相对价值。然而，在考虑为女性提供的最佳测试时，产科医生在产前检查时间和后续诊断测试相关风险方面的相对价值高于助产士。边际替代率表明，与助产士相比，如果测试更安全，产科医生会等待更长时间，并接受测试检出率更大幅度的下降。年轻助产士对产前检查的检出率和安全性的重视程度高于年长助产士。女性产科医生对检查时间的重视程度高于男性产科医生。
澳大利亚和英国的产科医生对测试属性的重视程度几乎相同，两国的助产士也是如此。然而，产科医生和助产士对测试的态度存在差异。
