Comparison of performance of 3 serum-based Down syndrome screening tests according to prespecified detection rate, false-positive rate, and population

	Quadruple test (AFP, uE3, hCG, InhA at 15-20 weeks)		Combined test (NT, PAPP-A, hCG at 12 weeks)		Integrated test (NT and PAPP-A at 12 weeks plus AFP, uE3, hCG, InhA at 15-20 weeks)
DR (%)		FPR (%)		FPR (%)		FPR (%)
70		2.0		1.3		0.2
80		4.5		3.6		0.7
90		11.7		11.7		3.2
FPR (%)	DR (%)		DR (%)		DR (%)
1	62		67		83
3	75		78		90
5	81		83		93
Risk cutoff (1:N)	DR (%)	FPR (%)	DR (%)	FPR (%)	DR (%)	FPR (%)
1:100	74	2.5	75	1.9	85	1.3
1:200	82	4.7	81	3.8	89	2.4
1:300	86	6.6	84	5.5	91	3.4

Because the combined test does not include AFP, screening for neural tube defects (if desired) needs to be performed separately. The quadruple test is the only one of these tests that does not require availability of ultrasound to measure nuchal translucency. All 3 tests will report an increased risk for trisomy 18, if present. All results assume the pregnancy is dated by ultrasound, serum markers are corrected for maternal weight, and total hCG is measured (if the free beta subunit measurement is used, the performance is expected to be slightly improved).

DR: detection rate; FPR: false-positive rate; AFP: alpha-fetoprotein; uE3: unconjugated estriol; inhA: inhibin A; PAPP-A: pregnancy associated plasma protein A; NT: nuchal translucency; hCG: human chorionic gonadotropin.

Data from: Wald NJ, Rodeck C, Hackshaw AK, et al. First and second trimester antenatal screening for Down's syndrome: the results of the Serum, Urine and Ultrasound Screening Study (SURUSS). Health Technol Assess 2003; 7:1.

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خرید پکیج

Comparison of performance of 3 serum-based Down syndrome screening tests according to prespecified detection rate, false-positive rate, and population