OPTIMIZING PRENATAL TESTING DECISION MAKING

优化产前检测决策

• 批准号: 2209574
• 负责人: ARNOLD E. WASHINGTON
• 金额: $ 27.55万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-09-25 至 1998-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2209574
• 关键词: African American; Asian Americans; Downs syndrome; Hispanic Americans; age at pregnancy; amniocentesis; caucasian American; chorionic villus sampling; chromosome disorders; decision making; genetic counseling; genetic disorder diagnosis; health behavior; health care service availability; health care service utilization; health economics; human pregnant subject; interview; preference; pregnancy; prenatal diagnosis; racial /ethnic difference; socioeconomics; statistics /biometry; women's health

This is a proposal for a study of the role of patient preferences and other factors in choices regarding use of prenatal screening for and diagnosis Of chromosomal disorders in a racially/ethnically diverse population. We propose to explore the distribution of prenatal screening and diagnosis choices made at our institution, which serves a racially/ethnically and socioeconomically diverse population. We also will collect detailed information regarding the distribution of individual preferences for test characteristics and outcomes by racial/ethnic group, as well as other factors which may be related to choices regarding the use of these tests. These data will be collected from women in the obstetrics clinics, to capture the preferences of all pregnant women who will be 35 or older at the time of delivery, not just those who attend genetic counseling. State-of-the-art preference measurement methods, including visual analog scaling and the standard gamble, will be used to elicit preferences from women who are facing a decision to undergo-or forgo-testing, and which test to use. Using both decision-analytic and regression techniques, we will compare "predicted" choices (based on expected utility theory) to actual choices made, and we will analyze the contribution of patient preferences and other factors in the choices we observe. We also will explore the cost effectiveness of current and proposed age- and risk-based guidelines for prenatal testing, and compare them to the estimated cost effectiveness of a reference-based guideline. Information generated in this study will ultimately be used in the development of a decision-assisting technology to help women of diverse backgrounds make informed choices regarding testing that reflect their underlying preferences, and in the delineation of guidelines for use of prenatal diagnostic services that place greater emphasis on patient presences and values, in addition to risk.

这是研究患者偏好和 有关使用产前筛查的选择和其他因素 种族/种族多样性中染色体疾病的诊断 人口。我们建议探索产前筛查的分布 和我们机构做出的诊断选择 种族/种族和社会经济多样化的人群。我们也是 将收集有关分布的详细信息 个人对测试特征和结果的偏好 种族/种族群体以及其他可能与 有关使用这些测试的选择。这些数据将被收集 从妇女诊所的妇女捕捉所有人的偏好 交货时将35岁或以上的孕妇，不仅仅是 那些参加遗传咨询的人。最新的偏好 测量方法，包括视觉模拟缩放和标准 赌博，将被用来引起面临的女性的偏好 决定接受或放弃测试，以及使用哪些测试。两者都使用 决策分析和回归技术，我们将比较“预测” 选择（基于预期效用理论）， 我们将分析患者偏好和其他因素的贡献 在我们观察到的选择中。我们还将探索成本效益 目前和拟议的基于年龄和风险的产前指南 测试，并将它们与A的估计成本效益进行比较 基于参考的指南。本研究中产生的信息将 最终在 开发决策技术，以帮助多样化的妇女 背景做出了有关反映其测试的明智选择 基础偏好，以及使用指南 产前诊断服务更加重视患者 除了风险外，存在和价值观。