Computerized Prenatal Genetic Testing Decision-Assisting Tool: A Randomized Controlled Trial
Guidelines for fetal aneuploidy testing recommend that screening and diagnostic testing be made available to pregnant women of all ages and that providers explain the differences between these tests to help their patients make informed testing decisions. We sought to estimate the effect of a compute...
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| Veröffentlicht in: | Obstetrics and gynecology (New York. 1953) 2009-01, Vol.113 (1), p.53-63 |
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| container_title | Obstetrics and gynecology (New York. 1953) |
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| creator | Kuppermann, Miriam Norton, Mary E. Gates, Elena Gregorich, Steven E. Learman, Lee A. Nakagawa, Sanae Feldstein, Vickie A. Lewis, James Washington, A Eugene Nease, Robert F. |
| description | Guidelines for fetal aneuploidy testing recommend that screening and diagnostic testing be made available to pregnant women of all ages and that providers explain the differences between these tests to help their patients make informed testing decisions. We sought to estimate the effect of a computerized, interactive prenatal testing decision tool on prenatal testing decision making.
Four hundred ninety-six English- or Spanish-speaking women at 20 or fewer weeks of gestation were randomly assigned to view the interactive prenatal testing decision tool or the California Department of Health Services' educational booklet. Primary outcomes were knowledge, risk awareness, intervention satisfaction, decisional conflict, and among women aged at least 35 years, use of invasive diagnostic testing.
Women assigned to the interactive prenatal testing decision tool had higher knowledge scores (79.5% compared with 64.9%, P |
| doi_str_mv | 10.1097/AOG.0b013e31818e7ec4 |
| format | Article |
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Four hundred ninety-six English- or Spanish-speaking women at 20 or fewer weeks of gestation were randomly assigned to view the interactive prenatal testing decision tool or the California Department of Health Services' educational booklet. Primary outcomes were knowledge, risk awareness, intervention satisfaction, decisional conflict, and among women aged at least 35 years, use of invasive diagnostic testing.
Women assigned to the interactive prenatal testing decision tool had higher knowledge scores (79.5% compared with 64.9%, P<.001), were more likely to correctly estimate their risk of procedure-related miscarriage (64.9% compared with 48.1%, P=.002) and carrying a Down syndrome-affected fetus (63.5% compared with 15.1%, P<.001), were more satisfied with the intervention (P<.001), and had less decision uncertainty (P<.001) than controls after viewing the intervention. Most of these differences persisted over time. Among women aged at least 35 years, the interactive prenatal testing decision tool viewers who were originally less inclined to undergo invasive testing were ultimately more likely than similarly inclined controls to have amniocentesis or chorionic villus sampling (44.8% compared with 29.2%), whereas those who were originally more inclined to undergo an invasive procedure ultimately were less likely than similarly inclined controls to have a diagnostic procedure (84.6% compared with 94.9%; P=.015 for interaction).
Using an interactive prenatal testing decision tool results in more informed prenatal genetic testing decisions than viewing standard educational booklets.
Clinicaltrials.gov, www.clinicaltrials.gov, NCT00686062
I.</description><identifier>ISSN: 0029-7844</identifier><identifier>EISSN: 1873-233X</identifier><identifier>DOI: 10.1097/AOG.0b013e31818e7ec4</identifier><identifier>PMID: 19104360</identifier><identifier>CODEN: OBGNAS</identifier><language>eng</language><publisher>Hagerstown, MD: by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Abortion, Eugenic ; Adult ; Amniocentesis ; Aneuploidy ; Biological and medical sciences ; Chorionic Villi Sampling ; Decision Making ; Decision Making, Computer-Assisted ; Down Syndrome - diagnosis ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Maternal Age ; Medical sciences ; Patient Education as Topic ; Patient Satisfaction ; Pregnancy ; Prenatal Diagnosis</subject><ispartof>Obstetrics and gynecology (New York. 1953), 2009-01, Vol.113 (1), p.53-63</ispartof><rights>by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3801-9c75d9f2dce7ffdac57c3d2129182351bd4b4c5ad61a747d8d7ff667a98432e03</citedby><cites>FETCH-LOGICAL-c3801-9c75d9f2dce7ffdac57c3d2129182351bd4b4c5ad61a747d8d7ff667a98432e03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21011790$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19104360$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kuppermann, Miriam</creatorcontrib><creatorcontrib>Norton, Mary E.</creatorcontrib><creatorcontrib>Gates, Elena</creatorcontrib><creatorcontrib>Gregorich, Steven E.</creatorcontrib><creatorcontrib>Learman, Lee A.</creatorcontrib><creatorcontrib>Nakagawa, Sanae</creatorcontrib><creatorcontrib>Feldstein, Vickie A.</creatorcontrib><creatorcontrib>Lewis, James</creatorcontrib><creatorcontrib>Washington, A Eugene</creatorcontrib><creatorcontrib>Nease, Robert F.</creatorcontrib><title>Computerized Prenatal Genetic Testing Decision-Assisting Tool: A Randomized Controlled Trial</title><title>Obstetrics and gynecology (New York. 1953)</title><addtitle>Obstet Gynecol</addtitle><description>Guidelines for fetal aneuploidy testing recommend that screening and diagnostic testing be made available to pregnant women of all ages and that providers explain the differences between these tests to help their patients make informed testing decisions. We sought to estimate the effect of a computerized, interactive prenatal testing decision tool on prenatal testing decision making.
Four hundred ninety-six English- or Spanish-speaking women at 20 or fewer weeks of gestation were randomly assigned to view the interactive prenatal testing decision tool or the California Department of Health Services' educational booklet. Primary outcomes were knowledge, risk awareness, intervention satisfaction, decisional conflict, and among women aged at least 35 years, use of invasive diagnostic testing.
Women assigned to the interactive prenatal testing decision tool had higher knowledge scores (79.5% compared with 64.9%, P<.001), were more likely to correctly estimate their risk of procedure-related miscarriage (64.9% compared with 48.1%, P=.002) and carrying a Down syndrome-affected fetus (63.5% compared with 15.1%, P<.001), were more satisfied with the intervention (P<.001), and had less decision uncertainty (P<.001) than controls after viewing the intervention. Most of these differences persisted over time. Among women aged at least 35 years, the interactive prenatal testing decision tool viewers who were originally less inclined to undergo invasive testing were ultimately more likely than similarly inclined controls to have amniocentesis or chorionic villus sampling (44.8% compared with 29.2%), whereas those who were originally more inclined to undergo an invasive procedure ultimately were less likely than similarly inclined controls to have a diagnostic procedure (84.6% compared with 94.9%; P=.015 for interaction).
Using an interactive prenatal testing decision tool results in more informed prenatal genetic testing decisions than viewing standard educational booklets.
Clinicaltrials.gov, www.clinicaltrials.gov, NCT00686062
I.</description><subject>Abortion, Eugenic</subject><subject>Adult</subject><subject>Amniocentesis</subject><subject>Aneuploidy</subject><subject>Biological and medical sciences</subject><subject>Chorionic Villi Sampling</subject><subject>Decision Making</subject><subject>Decision Making, Computer-Assisted</subject><subject>Down Syndrome - diagnosis</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Maternal Age</subject><subject>Medical sciences</subject><subject>Patient Education as Topic</subject><subject>Patient Satisfaction</subject><subject>Pregnancy</subject><subject>Prenatal Diagnosis</subject><issn>0029-7844</issn><issn>1873-233X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkVGL1DAQx4Mo3nr6DUT6om89Z5K0aXxbVl2FgxNZwQchZJOpV02bvaTl0E9vzl088CmT4fefhN8w9hzhAkGr1-ur7QXsAQUJ7LAjRU4-YCvslKi5EF8fshUA17XqpDxjT3L-AQDYavGYnaFGkKKFFfu2ieNhmSkNv8lXnxJNdrah2tJE8-CqHeV5mL5Xb8kNeYhTvc55OLZ2MYY31br6bCcfx7_xTZzmFEMo5S4NNjxlj3obMj07nefsy_t3u82H-vJq-3Gzvqyd6ABr7VTjdc-9I9X33rpGOeE5co0dFw3uvdxL11jfolVS-c4XrG2V1Z0UnECcs1fHuYcUb5byZTMO2VEIdqK4ZFPYVkvRFVAeQZdizol6c0jDaNMvg2DurJpi1fxvtcRenOYv-5H8feiksQAvT4DNzoY-2an4-sdxBESl4f792xiK8_wzLLeUzDXZMF-bsh9oeQM1B9CA5VbfrQzFH8r9kWo</recordid><startdate>20090101</startdate><enddate>20090101</enddate><creator>Kuppermann, Miriam</creator><creator>Norton, Mary E.</creator><creator>Gates, Elena</creator><creator>Gregorich, Steven E.</creator><creator>Learman, Lee A.</creator><creator>Nakagawa, Sanae</creator><creator>Feldstein, Vickie A.</creator><creator>Lewis, James</creator><creator>Washington, A Eugene</creator><creator>Nease, Robert F.</creator><general>by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090101</creationdate><title>Computerized Prenatal Genetic Testing Decision-Assisting Tool: A Randomized Controlled Trial</title><author>Kuppermann, Miriam ; Norton, Mary E. ; Gates, Elena ; Gregorich, Steven E. ; Learman, Lee A. ; Nakagawa, Sanae ; Feldstein, Vickie A. ; Lewis, James ; Washington, A Eugene ; Nease, Robert F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3801-9c75d9f2dce7ffdac57c3d2129182351bd4b4c5ad61a747d8d7ff667a98432e03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Abortion, Eugenic</topic><topic>Adult</topic><topic>Amniocentesis</topic><topic>Aneuploidy</topic><topic>Biological and medical sciences</topic><topic>Chorionic Villi Sampling</topic><topic>Decision Making</topic><topic>Decision Making, Computer-Assisted</topic><topic>Down Syndrome - diagnosis</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Maternal Age</topic><topic>Medical sciences</topic><topic>Patient Education as Topic</topic><topic>Patient Satisfaction</topic><topic>Pregnancy</topic><topic>Prenatal Diagnosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kuppermann, Miriam</creatorcontrib><creatorcontrib>Norton, Mary E.</creatorcontrib><creatorcontrib>Gates, Elena</creatorcontrib><creatorcontrib>Gregorich, Steven E.</creatorcontrib><creatorcontrib>Learman, Lee A.</creatorcontrib><creatorcontrib>Nakagawa, Sanae</creatorcontrib><creatorcontrib>Feldstein, Vickie A.</creatorcontrib><creatorcontrib>Lewis, James</creatorcontrib><creatorcontrib>Washington, A Eugene</creatorcontrib><creatorcontrib>Nease, Robert F.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kuppermann, Miriam</au><au>Norton, Mary E.</au><au>Gates, Elena</au><au>Gregorich, Steven E.</au><au>Learman, Lee A.</au><au>Nakagawa, Sanae</au><au>Feldstein, Vickie A.</au><au>Lewis, James</au><au>Washington, A Eugene</au><au>Nease, Robert F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Computerized Prenatal Genetic Testing Decision-Assisting Tool: A Randomized Controlled Trial</atitle><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle><addtitle>Obstet Gynecol</addtitle><date>2009-01-01</date><risdate>2009</risdate><volume>113</volume><issue>1</issue><spage>53</spage><epage>63</epage><pages>53-63</pages><issn>0029-7844</issn><eissn>1873-233X</eissn><coden>OBGNAS</coden><abstract>Guidelines for fetal aneuploidy testing recommend that screening and diagnostic testing be made available to pregnant women of all ages and that providers explain the differences between these tests to help their patients make informed testing decisions. We sought to estimate the effect of a computerized, interactive prenatal testing decision tool on prenatal testing decision making.
Four hundred ninety-six English- or Spanish-speaking women at 20 or fewer weeks of gestation were randomly assigned to view the interactive prenatal testing decision tool or the California Department of Health Services' educational booklet. Primary outcomes were knowledge, risk awareness, intervention satisfaction, decisional conflict, and among women aged at least 35 years, use of invasive diagnostic testing.
Women assigned to the interactive prenatal testing decision tool had higher knowledge scores (79.5% compared with 64.9%, P<.001), were more likely to correctly estimate their risk of procedure-related miscarriage (64.9% compared with 48.1%, P=.002) and carrying a Down syndrome-affected fetus (63.5% compared with 15.1%, P<.001), were more satisfied with the intervention (P<.001), and had less decision uncertainty (P<.001) than controls after viewing the intervention. Most of these differences persisted over time. Among women aged at least 35 years, the interactive prenatal testing decision tool viewers who were originally less inclined to undergo invasive testing were ultimately more likely than similarly inclined controls to have amniocentesis or chorionic villus sampling (44.8% compared with 29.2%), whereas those who were originally more inclined to undergo an invasive procedure ultimately were less likely than similarly inclined controls to have a diagnostic procedure (84.6% compared with 94.9%; P=.015 for interaction).
Using an interactive prenatal testing decision tool results in more informed prenatal genetic testing decisions than viewing standard educational booklets.
Clinicaltrials.gov, www.clinicaltrials.gov, NCT00686062
I.</abstract><cop>Hagerstown, MD</cop><pub>by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>19104360</pmid><doi>10.1097/AOG.0b013e31818e7ec4</doi><tpages>11</tpages></addata></record> |
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| identifier | ISSN: 0029-7844 |
| ispartof | Obstetrics and gynecology (New York. 1953), 2009-01, Vol.113 (1), p.53-63 |
| issn | 0029-7844 1873-233X |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Abortion, Eugenic Adult Amniocentesis Aneuploidy Biological and medical sciences Chorionic Villi Sampling Decision Making Decision Making, Computer-Assisted Down Syndrome - diagnosis Female Gynecology. Andrology. Obstetrics Humans Maternal Age Medical sciences Patient Education as Topic Patient Satisfaction Pregnancy Prenatal Diagnosis |
| title | Computerized Prenatal Genetic Testing Decision-Assisting Tool: A Randomized Controlled Trial |
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