Ethnic-specific reference range affects the efficacy of quadruple test as a universal screening for Down syndrome in a developing country.

<h4>Objective</h4>To evaluate the efficacy of the quadruple test for potential use as a Thai national policy for Down syndrome (DS) screening and establish an accurate equation for risk estimation of Down syndrome based on gestational age, weight and the ethnic-specific reference range o...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Savitree Pranpanus, Ounjai Kor-Anantakul, Thitima Suntharasaj, Chitkasaem Suwanrath, Tharangrut Hanprasertpong, Ninlapa Pruksanusak, Chusana Petpichetchian, Manaphat Suksai, Natthicha Chainarong, Rapphon Sawaddisan
Formato: article
Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2021
Materias:
R
Q
Acceso en línea:https://doaj.org/article/5698c3137b0944b8a400738fc352068b
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:5698c3137b0944b8a400738fc352068b
record_format dspace
spelling oai:doaj.org-article:5698c3137b0944b8a400738fc352068b2021-12-02T20:05:34ZEthnic-specific reference range affects the efficacy of quadruple test as a universal screening for Down syndrome in a developing country.1932-620310.1371/journal.pone.0251381https://doaj.org/article/5698c3137b0944b8a400738fc352068b2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251381https://doaj.org/toc/1932-6203<h4>Objective</h4>To evaluate the efficacy of the quadruple test for potential use as a Thai national policy for Down syndrome (DS) screening and establish an accurate equation for risk estimation of Down syndrome based on gestational age, weight and the ethnic-specific reference range of our population.<h4>Methods</h4>A prospective study was conducted on singleton pregnancies at 14 to 21 weeks of gestation to evaluate the efficacy of quadruple DS screening using the automatically calculated Western European descent factor (WF) in our population and the impact of screening using a specific Thai ethnic factor as well as to establish an equation for the risk estimation of DS based on gestational age, weight and a local Thai ethnic factor to correct for the impact of ethnic factor on the screening efficacy.<h4>Results</h4>Of a total of 5,515 women, 12 cases of DS and 8 cases of other aneuploidies were found. The detection rate, false positive rate and specificity were 75.0%, 9.1% and 90.9%, respectively, by automatic calculation with the widely used WF; the screening efficacy was lower when used in Asian populations than in other studies. The best-fitted regression equation of serum quadruple screening of AFP, free β-hCG, uE3 and inhibin A was established by adjustment for gestational age (GA) in days, maternal weight and our Thai-specific ethnic reference range which was created for this study. Calculations with our Thai-specific ethnic model gave a better detection rate of 83.3%, a false positive rate of 9.6% and specificity of 90.4%.<h4>Conclusion</h4>The serum quadruple test had a lower detection rate than expected when the risk estimation was based on the WF reference range. The serum quadruple test using WF had significantly different levels when corrected with our ethnic-specific factor. Using our local ethnic specific model could increase the detection rate of DS screening in Thailand with a minimal increase in false positive rates. Our findings indicate that DS screening should be adjusted with an appropriate individual ethnic factor when used for national screening.Savitree PranpanusOunjai Kor-AnantakulThitima SuntharasajChitkasaem SuwanrathTharangrut HanprasertpongNinlapa PruksanusakChusana PetpichetchianManaphat SuksaiNatthicha ChainarongRapphon SawaddisanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251381 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Savitree Pranpanus
Ounjai Kor-Anantakul
Thitima Suntharasaj
Chitkasaem Suwanrath
Tharangrut Hanprasertpong
Ninlapa Pruksanusak
Chusana Petpichetchian
Manaphat Suksai
Natthicha Chainarong
Rapphon Sawaddisan
Ethnic-specific reference range affects the efficacy of quadruple test as a universal screening for Down syndrome in a developing country.
description <h4>Objective</h4>To evaluate the efficacy of the quadruple test for potential use as a Thai national policy for Down syndrome (DS) screening and establish an accurate equation for risk estimation of Down syndrome based on gestational age, weight and the ethnic-specific reference range of our population.<h4>Methods</h4>A prospective study was conducted on singleton pregnancies at 14 to 21 weeks of gestation to evaluate the efficacy of quadruple DS screening using the automatically calculated Western European descent factor (WF) in our population and the impact of screening using a specific Thai ethnic factor as well as to establish an equation for the risk estimation of DS based on gestational age, weight and a local Thai ethnic factor to correct for the impact of ethnic factor on the screening efficacy.<h4>Results</h4>Of a total of 5,515 women, 12 cases of DS and 8 cases of other aneuploidies were found. The detection rate, false positive rate and specificity were 75.0%, 9.1% and 90.9%, respectively, by automatic calculation with the widely used WF; the screening efficacy was lower when used in Asian populations than in other studies. The best-fitted regression equation of serum quadruple screening of AFP, free β-hCG, uE3 and inhibin A was established by adjustment for gestational age (GA) in days, maternal weight and our Thai-specific ethnic reference range which was created for this study. Calculations with our Thai-specific ethnic model gave a better detection rate of 83.3%, a false positive rate of 9.6% and specificity of 90.4%.<h4>Conclusion</h4>The serum quadruple test had a lower detection rate than expected when the risk estimation was based on the WF reference range. The serum quadruple test using WF had significantly different levels when corrected with our ethnic-specific factor. Using our local ethnic specific model could increase the detection rate of DS screening in Thailand with a minimal increase in false positive rates. Our findings indicate that DS screening should be adjusted with an appropriate individual ethnic factor when used for national screening.
format article
author Savitree Pranpanus
Ounjai Kor-Anantakul
Thitima Suntharasaj
Chitkasaem Suwanrath
Tharangrut Hanprasertpong
Ninlapa Pruksanusak
Chusana Petpichetchian
Manaphat Suksai
Natthicha Chainarong
Rapphon Sawaddisan
author_facet Savitree Pranpanus
Ounjai Kor-Anantakul
Thitima Suntharasaj
Chitkasaem Suwanrath
Tharangrut Hanprasertpong
Ninlapa Pruksanusak
Chusana Petpichetchian
Manaphat Suksai
Natthicha Chainarong
Rapphon Sawaddisan
author_sort Savitree Pranpanus
title Ethnic-specific reference range affects the efficacy of quadruple test as a universal screening for Down syndrome in a developing country.
title_short Ethnic-specific reference range affects the efficacy of quadruple test as a universal screening for Down syndrome in a developing country.
title_full Ethnic-specific reference range affects the efficacy of quadruple test as a universal screening for Down syndrome in a developing country.
title_fullStr Ethnic-specific reference range affects the efficacy of quadruple test as a universal screening for Down syndrome in a developing country.
title_full_unstemmed Ethnic-specific reference range affects the efficacy of quadruple test as a universal screening for Down syndrome in a developing country.
title_sort ethnic-specific reference range affects the efficacy of quadruple test as a universal screening for down syndrome in a developing country.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/5698c3137b0944b8a400738fc352068b
work_keys_str_mv AT savitreepranpanus ethnicspecificreferencerangeaffectstheefficacyofquadrupletestasauniversalscreeningfordownsyndromeinadevelopingcountry
AT ounjaikoranantakul ethnicspecificreferencerangeaffectstheefficacyofquadrupletestasauniversalscreeningfordownsyndromeinadevelopingcountry
AT thitimasuntharasaj ethnicspecificreferencerangeaffectstheefficacyofquadrupletestasauniversalscreeningfordownsyndromeinadevelopingcountry
AT chitkasaemsuwanrath ethnicspecificreferencerangeaffectstheefficacyofquadrupletestasauniversalscreeningfordownsyndromeinadevelopingcountry
AT tharangruthanprasertpong ethnicspecificreferencerangeaffectstheefficacyofquadrupletestasauniversalscreeningfordownsyndromeinadevelopingcountry
AT ninlapapruksanusak ethnicspecificreferencerangeaffectstheefficacyofquadrupletestasauniversalscreeningfordownsyndromeinadevelopingcountry
AT chusanapetpichetchian ethnicspecificreferencerangeaffectstheefficacyofquadrupletestasauniversalscreeningfordownsyndromeinadevelopingcountry
AT manaphatsuksai ethnicspecificreferencerangeaffectstheefficacyofquadrupletestasauniversalscreeningfordownsyndromeinadevelopingcountry
AT natthichachainarong ethnicspecificreferencerangeaffectstheefficacyofquadrupletestasauniversalscreeningfordownsyndromeinadevelopingcountry
AT rapphonsawaddisan ethnicspecificreferencerangeaffectstheefficacyofquadrupletestasauniversalscreeningfordownsyndromeinadevelopingcountry
_version_ 1718375481962659840