Cost-effectiveness and Down syndrome.

Abstract

Comments on the article by M. Serra-Prat et al (see record 1998-10101-001) describing different screening policies for prenatal detection of Down syndrome that would allow decision makers to make informed choices. The commentators present several problems with Serra-Prat et al's original analysis. First, they point out that the perspective of the study is not clearly defined. The presented decision analysis may do little to help patients and clinicians with difficult decisions. The commentators suggest small changes that could be made to adjust the sensitivity and specificity of the tool that would greatly increase its clinical utility. Further, the commentators note that the work by Serra-Prat et al is in fact a policy analysis for the detection of Down syndrome in the Catalonian population where this study was originally done. They also note the cost-effectiveness analysis assesses average instead of incremental cost-effectiveness ratios. Finally, the commentators address the question of which outcome measure to use. They suggest that the original authors carefully select the options so as to include only those that are clinically relevant and that the inclusion of an option that is irrelevant in many countries (no screening) can bias the analysis and give false results. (PsycINFO Database Record (c) 2016 APA, all rights reserved)