Document Detail


Median parameters for Down's syndrome screening should be calculated using a moving time-window method.
MedLine Citation:
PMID:  18768535     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In Down's syndrome screening, the change in analyte concentrations in maternal serum with advancing gestational age is compensated for by converting concentration to multiples of the median (MoM) by using a mathematical equation describing the expected relationship. However, owing to assay drifts and shift, the equation may be incorrect, leading to deviation of the observed MoM distribution from the ideal MoM distribution. The NHS Fetal Anomaly Screening Programme has produced standards limiting acceptable deviation, and has provided the Down's Syndrome Screening Quality Assurance Service (DQASS) to monitor it. DQASS recommends monitoring by cumulative sum plot. METHODS: Down's screening data for 61,368 consecutive samples (12 October 2004 to 31 December 2007) was evaluated using different median assignment techniques. RESULTS: A change in the paradigm for median equation derivation is described, which significantly improves the probability that medians will be correct at any point in time. CONCLUSION: Software developers need to change the way medians are derived in their programmes.
Authors:
T M Reynolds; J Aldis
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Publication Detail:
Type:  Journal Article     Date:  2008-09-03
Journal Detail:
Title:  Annals of clinical biochemistry     Volume:  45     ISSN:  0004-5632     ISO Abbreviation:  Ann. Clin. Biochem.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-22     Completed Date:  2009-02-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0324055     Medline TA:  Ann Clin Biochem     Country:  England    
Other Details:
Languages:  eng     Pagination:  567-70     Citation Subset:  IM    
Affiliation:
Clinical Chemistry Department, Queen's Hospital, Belvedere Road, Burton-on-Trent, Staffordshire DE13 0RB. Tim.Reynolds@Burtonh-tr.wmids.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Chorionic Gonadotropin, beta Subunit, Human / blood
Down Syndrome / blood*,  diagnosis*
Estriol / blood
Female
Gestational Age
Humans
Maternal-Fetal Exchange
Pregnancy
Prenatal Diagnosis / methods*,  standards,  statistics & numerical data
Quality Control
alpha-Fetoproteins / analysis
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Chorionic Gonadotropin, beta Subunit, Human; 0/alpha-Fetoproteins; 50-27-1/Estriol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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