Has Noninvasive Prenatal Testing (NIPT) Come of Age?

Allahbadia, Gautam N.

doi:10.1007/s13224-015-0718-5

Cited by 3 publications

(3 citation statements)

References 21 publications

(45 reference statements)

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“…In January 2015, HUS was the first public hospital in Finland to implement non-invasive prenatal testing (NIPT) as an alternative further testing method to chorionic villus sampling (CVS) and amniocentesis. NIPT is based on next-generation cell-free DNA sequencing in maternal plasma to assess the most common fetal aneuploidies (Allahbadia et al, 2015;Kellogg et al, 2014). As NIPT uses blood samples, pregnancy loss is not a risk (compared to CVS and amniocentesis).…”

Section: Resultsmentioning

confidence: 99%

Context-based patient choice management in healthcare

Chen

Lillrank

Tenhunen

et al. 2018

IJHCQA

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Purpose In healthcare, there is limited knowledge of and experience with patient choice management. The purpose of this paper is to focus on patient choice, apply and test demand-supply-based operating (DSO) logic integrated with clinical setting in clarifying choice contexts, investigate patient's choice-making at different contexts and suggest context-based choice architectures to manage and develop patient choice. Design/methodology/approach Prenatal screening and testing in the Helsinki and Uusimaa Hospital District (HUS), Finland, was taken as an example. Choice points were contextualized by using the DSO framework. Women's reflections, behaviors and experience at different choice contexts were studied by interviewing women participating in prenatal screening and testing. Semi-structured interview data were processed by thematic analysis. Findings By applying DSO logic, four choice contexts (prevention, cure, electives and continuous care) were relevant in the prenatal screening and testing episode. Women had different choice-making in prevention and cure mode contexts regarding choice activeness, information needs, social influence, preferences, emotion status and choice-making difficulty. Default choice was widely accepted by women in prevention mode and individual counseling can help women make informed choice in cure mode. Originality/value The authors apply the DSO model to contextualize the patient choice in one care episode and compare patient choice-making at different contexts. The authors also suggest the possible context-based choice architectures to manage and promote patient choice.

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Section: Resultsmentioning

confidence: 99%

Context-based patient choice management in healthcare

Chen

Lillrank

Tenhunen

et al. 2018

IJHCQA

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“…In contrast, NIPT, which is based on next-generation sequencing of cell-free fetal DNA in maternal plasma to assess the most common fetal aneuploidies, only uses maternal blood samples [6]. The weakness of NIPT is its false positive rates, which, although very small, require confirmation of the result by invasive procedures [7]. …”

Section: Introductionmentioning

confidence: 99%

Considering medical risk information and communicating values: A mixed-method study of women’s choice in prenatal testing

et al. 2017

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IntroductionNowadays, an important decision for pregnant women is whether to undergo prenatal testing for aneuploidies and which tests to uptake. We investigate the factors influencing women’s choices between non-invasive prenatal testing (NIPT) and invasive prenatal tests in pregnancies with elevated a priori risk of fetal aneuploidies.MethodologyThis is a mixed-method study. We used medical data (1st Jan 2015-31st Dec 2015) about women participating in further testing at Fetomaternal Medical Center at Helsinki University Hospital and employed Chi-square tests and ANOVA to compare the groups of women choosing different methods. Multinomial logistic regressions revealed the significant clinical factors influencing women’s choice. We explored the underlying values, beliefs, attitudes and other psychosocial factors that affect women’s choice by interviewing women with the Theory of Planned Behavior framework. The semi-structured interview data were processed by thematic analysis.ResultsStatistical data indicated that gestational age and counseling day were strong factors influencing women’s choice. Interview data revealed that women’s values and moral principles on pregnancy and childbirth chiefly determined the choices. Behavioral beliefs (e.g. safety and accuracy) and perceived choice control (e.g. easiness, rapidness and convenience) were also important and the major trade-offs happened between these constructs.DiscussionValues are the determinants of women’s choice. Service availability and convenience are strong factors. Medical risk status in this choice context is not highly influential. Choice aids can be developed by helping women to identify their leading values in prenatal testing and by providing lists of value-matching test options and attributes.

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“…Amniocentesis and CVS provide an accurate diagnosis but carry a miscarriage risk . In contrast, NIPT, which is based on the next‐generation sequencing of cell‐free DNA in maternal plasma to assess the most common fetal aneuploidies, only uses blood samples and thus largely reduces the risk of pregnancy loss . However, because of NIPT's false positive rates, NIPT is not a diagnostic test but an advanced screening test provided as an option with non‐absolute advantages in prenatal screening and testing paradigm .…”

Section: Introductionmentioning

confidence: 99%