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Re: abnl triple screenFrom: ATB28@aol.comThu Mar 6 09:27:50 1997
In a message dated 97-03-05 19:37:43 EST, Snorklesue@aol.com writes: << Since we're talking about triple screen, what do you quote your pts as false positive rate of triple screen for Down's syndrome? Are there references to this?
Susan Lee, MD
Womack Army MedCen
>> The screen positive rate varies from lab to lab, and also from population to population screened. The latter is principally dependent upon the prevalence rate for the condition screened in the population. For example, in screening a cohort of women who's mean age is 40, one would expect a screen positive rate of 25% or greater (and a detection rate better than 85%) - see the NEJM article by Haddow et al on screening efficiency in women older than age 34 years. In screening *younger* women, most labs fix the screen positive rate at ~5%, and manifest a detection rate (using double or triple markers) of 56-64%. Ideally, the addition of other markers (inhibin-A, NAP, nuchal translucency, PAPP-A, fetal cells in maternal serum) will increase the detection rate at no increase in the screen positive rate. As screening moves into the first trimester, a time in gestation in which the prevalence for aneuploidy increases (although many are lost subsequently), one would expect the detection rate, and the screen positive rate to increase. It is likely that some combination of serum, urine, and ultrasound markers will ultimately be found which optimizes both sensitivity, specificity, and positive predictive value. Allan T. Bombard, MD Reproductive Genetics Dept Obs-Gyn AECOM/MMC Bronx, NY
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