Brewer Justin, Demers Lisa, Musci Thomas
a Department of Maternal Fetal Medicine , North Mississippi Medical Center Women's Hospital , Tupelo , MS , USA.
b Medical and Scientific Affairs, Roche Diagnostics Corporation , Indianapolis , IN , USA , and.
J Matern Fetal Neonatal Med. 2017 Aug;30(15):1793-1796. doi: 10.1080/14767058.2016.1225035. Epub 2016 Sep 2.
To evaluate the knowledge and opinions of US obstetric providers who use noninvasive prenatal testing (NIPT) to understand current utilization and guide future best practices.
A questionnaire was designed to assess the level of knowledge and attitudes of OBGYNs toward screening options for aneuploidy, with a focus on NIPT. Initial questions evaluated obstetrician demographics, practice type, and NIPT familiarity. Subsequent questions were designed to solicit current practices regarding aneuploidy screening as well as opinions, experiences, and implications of NIPT.
Survey respondents identified NIPT as clinically superior to traditional screening methods and indicated that they would like ACOG to formally recommend NIPT for any pregnant woman. Insurance coverage, and therefore cost, was noted as the biggest barrier, and over 81% of surveyed providers would utilize NIPT as a first-line screening test if patients' insurance offered full coverage. The majority of providers who have implemented NIPT into clinical practice indicated improved patient care. While most providers demonstrated accurate understanding of the technology and its application, nearly 15% misunderstood NIPT as being a diagnostic test for fetal aneuploidy.
The results of the survey suggest that there is a desire for changes to current practice guidelines and insurance coverage. Additionally, provider education remains paramount.
评估美国使用无创产前检测(NIPT)的产科医疗服务提供者的知识水平和观点,以了解当前的使用情况并指导未来的最佳实践。
设计了一份问卷,以评估妇产科医生对非整倍体筛查选项的知识水平和态度,重点是NIPT。初始问题评估产科医生的人口统计学特征、执业类型和对NIPT的熟悉程度。后续问题旨在征集有关非整倍体筛查的当前实践以及NIPT的观点、经验和影响。
调查受访者认为NIPT在临床上优于传统筛查方法,并表示希望美国妇产科医师学会(ACOG)正式向任何孕妇推荐NIPT。保险覆盖范围以及由此产生的费用被指出是最大的障碍,如果患者的保险提供全额覆盖,超过81%的接受调查的医疗服务提供者会将NIPT用作一线筛查测试。大多数已将NIPT应用于临床实践的医疗服务提供者表示患者护理得到了改善。虽然大多数医疗服务提供者对该技术及其应用表现出准确的理解,但近15%的人误解NIPT为胎儿非整倍体的诊断测试。
调查结果表明,人们希望对当前的实践指南和保险覆盖范围进行变革。此外,对医疗服务提供者的教育仍然至关重要。