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Re: MSAFP vs triple screenFrom: ATB28@aol.comMon Jul 14 06:59:02 1997
In a message dated 97-07-13 01:50:48 EDT, malcolm@mgriff22.demon.co.uk (Malcolm Griffiths) writes:
<< >screening is the process of first choice in low risk patients (such as
those
>< age 35 years). Whilst I agree that the original poster may have not got things quite right I strongly disagree with your assertion that serum screening is inappropriate in >35 year olds. It is a perfectly legitimate choice which allows avoidance of amnio risk of ~1% whilst accepting a risk of <1:1,000 of a false negative. I had a 42year old chose serum screening this morning ! Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt >> Malcolm: I didn't state that it was *inappropriate* ; rather, that it...screening (using triple markers)... is our process of first choice. In addition, the risk you state (1%) for amniocentesis - while perhaps accurate at your referral centers - is different than our experience (0.25% over background) in > 25,000 procedures. It's all about informed consent, current practice standards, local expertise, and costs. We too follow trends in the UK, and look forward to your collective movements into first trimester screening, the incorporation of ultrasound in the screening process (and the cost impact we'll see in the US), and the transfer of multiple marker screening in the US from double/triple to quad testing (inhibin-A). Please keep us posted! Allan
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