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- W2020456960 abstract "Several models have been suggested for the computation of patient-specific risks for Down syndrome based upon nuchal translucency (NT). Each allows to derive a likelihood ratio (LR) for a value of crown–rump length (CRL) and NT. Although these models achieve increasing detection rates for a fixed false-positive rate, the computation of the patient-specific risk itself may require undesirable assumptions. The objective is to investigate the behavior of the LR of NT. A simulation study was conducted using a specifically-designed implementation of the mixture model suggested by Wright & al. in 2008. Using this model with published parameters, the LR was computed as a function of NT for values ranging from 0.6 to 10 mm and for CRL ranging from 45 to 84 mm. Whereas one would expect the LR to be a strictly monotone increasing function of NT, the LR increases for smaller values of NT regardless of the CRL. This would mean finding a higher risk for smaller NT past a threshold. This minimum is reached for LRs as small as 0.1. When compared to the overall distribution of NT, the NT thresholds corresponding to this LR minimum range from the 10th to the 30th percentile across CRL, meaning that between 10 and 30% of patients will have an inconsistent value of their individual risk. This unexplained behavior of the LR therefore requires truncations to derive an individual risk. In other words, for nuchal translucencies below a certain threshold, the LR is constant. Although this will not provide a consistent patient-specific risk, it will prevent increasing risks in smaller NTs. Model assumptions may impair the interpretation of patient-specific NT LR. Although an undesirable behavior is found for low-risk patients based on NT, it may become prominent when facing a high biochemistry LR." @default.
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- W2020456960 date "2010-10-01" @default.
- W2020456960 modified "2023-10-01" @default.
- W2020456960 title "OP04.03: Pitfalls in modeling the individual risk of Down syndrome by age and nuchal translucency" @default.
- W2020456960 doi "https://doi.org/10.1002/uog.7956" @default.
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