Psychosocial aspects of decision making for prenatal screening: nuchal translucency scanning as a new screening alternative
Bibliographic record
Abstract
Background. New prenatal screening techniques increase women's options, but may complicate decision making. One such new option is nuchal translucency scanning (NTS), a non-invasive, first-trimester ultrasound screening approach. Objectives. (1) To evaluate the effects of a psychoeducational intervention; (2 & 3) To determine whether social and psychological factors associated with a desire to undergo prenatal testing, and factors associated with difficult decision making, predict the decision to undergo invasive testing; (4) to build a predictive model of the choice for invasive testing; (5) to evaluate whether psychological sequelae change, following group genetic counseling, and then again after NT-adjusted risks are received; (6) to determine whether reassuring NT-adjusted risks decrease the uptake rate of invasive prenatal testing. Sample. A consecutive series of 271 women attending a late maternal age clinic in a Canadian teaching hospital. Method. Baseline measures were used to assess psychological status, sociodemographic characteristics, and level of knowledge about prenatal diagnosis. Women were then exposed to a psychoeducational intervention, after which levels of knowledge, anxiety, risk perception, and decisional conflict were retested. For women who elected NTS and had reassuring results, measures were re-administered after adjusted risks were communicated. Analyses: Scores from social and psychological measures were analyzed using analyses of variance. Multiple regression analysis was used to assess the relative importance of the social and psychological predictors on the choice for invasive testing. Results. Knowledge increased, and decisional conflict decreased, after group genetic counseling. Predictors of invasive testing were: desire to know about fetal health; having discussed prenatal diagnosis with one's health practitioner; risk attitude, and choice of screening tests and screening results. Decisional conflict, anxiety and risk perception decreased after reassuring NTS results. Of the women who underwent NTS alone, 78% elected invasive testing. Uptake decreased to 8% when women also had reassuring maternal serum screening (MSS) results. Summary. Social and psychological factors play an integral role in women's decisions about prenatal testing. Women of advanced maternal age are willing to undergo NTS alone, but many are unwilling to forgo the certainty afforded by invasive testing. The effects of consistently reassuring screening results are worthy of further investigation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".