Postnatal economic burden of limited karyotyping

doi:10.1136/bmj.332.7542.668-c

BMJ 2006;332:668-669 (18 March), doi:10.1136/bmj.332.7542.668-c

Letter

Postnatal economic burden of limited karyotyping

The first 150 words of the full text of this article appear below.

EDITOR—Chitty et al suggest a strategy to identify chromosomalabnormalities that relies on quantitative fluorescent polymerasechain reaction (qf-PCR) and full karyotyping only in cases offetal nuchal translucency thickness > 4 mm, as opposed tofull karyotyping of all chorionic villous samples.¹ Eliminatingdouble testing results in an upfront economic savings of about£1.5m ( ${euro}$ 2.17m; $2.50m) distributed across 17 479 pregnancies.However, such an approach has a failure rate of 1%, the economicconsequences of which Chitty et al do not appreciate in theirdiscussion.

The incremental lifetime economic cost incurred by an infantborn with trisomy 21 is about £350 000 (adjusted for 2006currency).² Considering only chromosomally abnormal babies thatcame to term as well as those undetected by limited karyotyping,and given a reasonable termination rate of 70%, the six babiesthat would have been missed in the study alone represent aneconomic . . . [Full text of this article]

Suneel B Bhat, pre-medical student

sbhat@princeton.edu Princeton University, Princeton, NJ 08544, USA

Sanjay B Bhat, collaborator

Princeton University, Princeton, NJ 08544, USA

Jessica Stevens, chief paediatric resident

University of Medicine and Dentistry of New Jersey, New Jersey Medical School

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