Decision analysis and screening for Down's syndrome

BMJ 1995;311:1371 (18 November)

Letters

Decision analysis and screening for Down's syndrome

Estimate of uptake of amniocentesis is overoptimistic

EDITOR,--J Fletcher and colleagues raise many important issuesregarding the difficulties in making population policies forantenatal screening for Down's syndrome.¹ Unlike in some previousstudies, the authors give full attention to a wide range ofoutcome measures in their comparison of possible alternativepolicies rather than focusing simply on the number of casesof Down's syndrome detected. They also recognise that the weightgiven to each of these outcome measures varies significantlybetween individuals and groups of women, according to factorsincluding age, family status, and culture. They conclude, correctlywe think, that no single policy can meet the needs of all womenin the population and that policies should not be implementedtoo rigidly. Despite this, we wish to make several observationson the paper, which could influence the conclusions drawn fromit and policy decisions made.

Firstly, the authors' assumption . . . [Full text of this article]

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Relevant Article

Using decision analysis to compare policies for antenatal screening for Down's syndrome: J Fletcher, N R Hicks, J D S Kay, and P A Boyd
BMJ 1995 311: 351-356. [Abstract] [Full Text]