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Re: Benacerraf's Genetic Scoring SystemFrom: nyberg@u.washington.eduThu Jan 17 16:43:35 2002
It's true-there will be some critical age at which point we can't reduce the risk enough to fall below 'our' threshold. We think it's about age 40 and Beryl's scoring system also supports that. However, with higher sensitivity based on improved ultrasound and/or biochemistry, that critical age will be somewhere above that- maybe age 43 or 44. That is why we like to provide a specific risk estimates if possible. Something else to keep in mind though is that our threshold may not be the patient's threshold. Many women in this age range seem to be quite happy to hear that their risk is lower after the ultrasound or lab test, even if they are considered a positive screen. As always, it's a very personal decision. All we can do is provide the patient with the best information possible. While I have the podium for a minute, let me say that if we are willing to tell patients that they are at reduced risk based on a normal ultrasound, then we also should be prepared to tell them of their higher risk based on positive ultrasound markers. I believe that applies to all women whether they are considered low-risk (younger) or high-risk. In the case of low-risk women though, many will remain above our threshold even with a single sonographic marker. That is again supported by Beryl's scoring system. David On Thu, 17 Jan 2002, Allen Worrall wrote:
> That is not between the lines. Dr. Benacerraf and her group clearly say that
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