Skip to main content
Journal cover image

Cell-free DNA for Down syndrome screening in obese women: Is it a cost-effective strategy?

Publication ,  Journal Article
Hopkins, MK; Dugoff, L; Durnwald, C; Havrilesky, LJ; Dotters-Katz, S
Published in: Prenat Diagn
January 2020

OBJECTIVE: Determine cost differences between cell-free DNA (cfDNA) and serum integrated screening (INT) in obese women given the limitations of aneuploidy screening in this population. METHODS: Using a decision-analytic model, we estimated the cost-effectiveness of trisomy 21 screening in class III obese women using cfDNA compared with INT. Primary outcomes of the model were cost, number of unnecessary invasive tests, procedure-related fetal losses, and missed cases of trisomy 21. RESULTS: In base case, the mean cost of cfDNA was $498 greater than INT ($1399 vs $901). cfDNA resulted in lower probabilities of unnecessary invasive testing (2.9% vs 3.5%), procedure-related loss (0.015% vs 0.019%), and missed cases of T21 (0.00013% vs 0.02%). cfDNA cost $87 485 per unnecessary invasive test avoided, $11 million per procedure-related fetal loss avoided, and $2.2 million per missed case of T21 avoided. In sensitivity analysis, when the probability of insufficient fetal fraction is assumed to be >25%, cfDNA is both costlier than INT and results in more unnecessary invasive testing (a dominated strategy). CONCLUSION: When the probability of insufficient fetal fraction more than 25% (a maternal weight of ≥300 lbs), cfDNA is costlier and results in more unnecessary invasive testing than INT.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Prenat Diagn

DOI

EISSN

1097-0223

Publication Date

January 2020

Volume

40

Issue

2

Start / End Page

173 / 178

Location

England

Related Subject Headings

  • Stillbirth
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Obesity, Maternal
  • Noninvasive Prenatal Testing
  • Missed Diagnosis
  • Maternal Serum Screening Tests
  • Humans
  • Female
  • Down Syndrome
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hopkins, M. K., Dugoff, L., Durnwald, C., Havrilesky, L. J., & Dotters-Katz, S. (2020). Cell-free DNA for Down syndrome screening in obese women: Is it a cost-effective strategy? Prenat Diagn, 40(2), 173–178. https://doi.org/10.1002/pd.5605
Hopkins, Maeve K., Lorraine Dugoff, Celeste Durnwald, Laura J. Havrilesky, and Sarah Dotters-Katz. “Cell-free DNA for Down syndrome screening in obese women: Is it a cost-effective strategy?Prenat Diagn 40, no. 2 (January 2020): 173–78. https://doi.org/10.1002/pd.5605.
Hopkins MK, Dugoff L, Durnwald C, Havrilesky LJ, Dotters-Katz S. Cell-free DNA for Down syndrome screening in obese women: Is it a cost-effective strategy? Prenat Diagn. 2020 Jan;40(2):173–8.
Hopkins, Maeve K., et al. “Cell-free DNA for Down syndrome screening in obese women: Is it a cost-effective strategy?Prenat Diagn, vol. 40, no. 2, Jan. 2020, pp. 173–78. Pubmed, doi:10.1002/pd.5605.
Hopkins MK, Dugoff L, Durnwald C, Havrilesky LJ, Dotters-Katz S. Cell-free DNA for Down syndrome screening in obese women: Is it a cost-effective strategy? Prenat Diagn. 2020 Jan;40(2):173–178.
Journal cover image

Published In

Prenat Diagn

DOI

EISSN

1097-0223

Publication Date

January 2020

Volume

40

Issue

2

Start / End Page

173 / 178

Location

England

Related Subject Headings

  • Stillbirth
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Obesity, Maternal
  • Noninvasive Prenatal Testing
  • Missed Diagnosis
  • Maternal Serum Screening Tests
  • Humans
  • Female
  • Down Syndrome