Can Decision Analysis Help Us Decide Whether Ultrasound Screening for Fetal Anomalies Is Worth It

摘要: : Decision analysis is a widely used tool to improve clinical decision making when randomized controlled trials are infeasible, underpowered, or lack generalizability. We performed an exploratory of routine second trimester ultrasound detect fetal anomalies, focusing on the assumptions that would have greatest impact. Six outcome categories were considered: (1) abnormal ultrasound, anomalous child, (2) elective abortion fetus, (3) healthy (4) (5) normal and (6) child. Live birth death rates for nine sonographically detectable anomalies obtained from California Birth Defects Monitoring Program. The sensitivity specificity estimated through meta-analysis recent series. Plausible ranges probabilities cesarean delivery abortion, by anomaly, determined review literature. Standard gamble, willingness-to-pay, human capital estimates utility rescaled comparability. found appears be preferred strategy most women. This choice sensitive primarily women's willingness-to-pay reassurance ultrasound.