Women's preferences in screening for Down syndrome.

OBJECTIVES

In this article, we seek to establish women's preferences (expressed as utility values) for a number of scenarios relating to the process and associated outcomes of first- and second-trimester screening for Down syndrome.

METHODS

We used the standard gamble (SG) approach with a sample of 100 pregnant women. Standard gamble is a choice-based preference elicitation technique that values scenarios on a 0-1 scale.

RESULTS

A true negative screening test, whether obtained in the first or second trimester, had the highest utility scores (both 0.98), which were not significantly different from the scores for the false-positive scenarios leading to first- or second-trimester invasive testing but the birth of a healthy infant (0.95 and 0.94, respectively). The mean utility score for the false-negative scenario resulting in the birth of a Down syndrome infant (0.77) was lower than both the true negative scenarios and the false-positive healthy baby scenarios (p < 0.000).

CONCLUSION

We did not find any differences in the values of the key scenarios regarding either the timing of reassurance of a healthy fetus or the ability to access early surgical termination, rather than later medical termination for a Down syndrome fetus.