Economic and Organizational Issues in Prenatal Screening and Diagnosis of Down Syndrome
Bibliographic record
Abstract
<i>Objective:</i> To evaluate the economic and organizational issues in the introduction of maternal serum screening (MSS) for Down syndrome (DS) in Quebec. <i>Methods:</i> A literature review and an economic analysis were performed. Relevant ethical and organizational questions were examined. <i>Results:</i> MSS could double the number of detected cases, reduce the number of amniocenteses per detected case and the number of procedure-related miscarriage per detected case. Even though MSS is cost-effective, prenatal screening and diagnosis would detect only 50% or less of expected DS cases. <i>Conclusion:</i> Effectiveness and cost-effectiveness of prenatal diagnosis of DS are improved using MSS. In spite of this performance, prenatal screening and diagnosis bring about unaffected fetal losses. Voluntary participation to MSS based on a good understanding of risks and advantages of prenatal screening appears essential for ethical reasons. Organizational issues influencing the quality of care have to be taken into account in the policy-making process along with the results of the economic analysis.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".