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- W2997182451 abstract "Austere clinical settings within the military healthcare system pose unique challenges in screening for fetal aneuploidy. The objective of this study is to compare aneuploidy screening strategies in a military treatment facility with limited in-house perinatal resources. We identified Naval Hospital Guantanamo Bay as a surrogate for an austere prenatal clinical environment and performed a cost of care analysis to compare two aneuploidy screening strategies: the serum integrated and cell free DNA. The baseline screen opt-in rate was determined by reviewing all low risk subjects who presented for prenatal care < 20 weeks gestation over a six year period (2013-2018, n=48). Rates of diagnostic testing following a positive screen for trisomy 18/21 were derived from the literature. Test performance characteristics and costs were provided by the reference lab. Over the five year period, the screen opt-in rate was calculated at 90%. Screening using the serum integrated would cost $3,332.91 over six years versus $17,756.89 with cell free DNA. Traditional screening would result in 2.2 positive tests versus 0.2 using cell free DNA, leading to 0.87 versus 0.14 diagnostic testing procedures. The integrated screen will detect 90% and 88% of fetuses with Trisomy 18 and 21 respectively versus 98% and 99% for cell free DNA. As an initial screening strategy, cell free DNA for low risk women offers enhanced detection rates for Trisomy 18/21 with a lower false positive rate and need for confirmatory diagnostic testing but costs five times more than traditional screening. In a low volume setting with limited resources, the added cost may be justified given the implications of unrecognized aneuploidy." @default.
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- W2997182451 date "2020-01-01" @default.
- W2997182451 modified "2023-10-18" @default.
- W2997182451 title "1003: Optimizing fetal aneuploidy screening in an austere military clinical environment: A cost of care analysis" @default.
- W2997182451 doi "https://doi.org/10.1016/j.ajog.2019.11.1019" @default.
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