() Historical III-3 Aim: to assess changes in rates of invasive Following the introduction of the control diagnostic prenatal procedures associated number of amniocenteses performed in with combined first trimester screening and Australia fell by 51% between the first quarter cfDNA of 2013 and the final quarter of 2014 (1,560 vs 758. OR 0.48; 95% CI: 0.44–0.53; = 282, Setting: Australia 2 P<0.005). The total number of CVS fell by Population: invasive procedures claimed 37% over the same period (767 vs 481. OR through Medicare from 1994 to 2014 0.63; 95% CI: 0.56–0.70; = 66, P<0.005). This 2 Method: analysis of data from the Medicare represents the largest annual decrease in Australia Medical Benefits Scheme (MBS) invasive procedures during the 20-year study database on procedural item numbers period. 16600 (diagnostic amniocentesis) and 16603 This change has important implications for (chorionic villus sampling [CVS] by any training in, and maintenance of, the route) for the period 1994 to 2014 inclusive, procedural skills of amniocentesis and CVS. by calendar year Outcomes: changes in of invasive diagnostic tests () Historical III-3 500 Aim: To assess the impact of cfDNA testing The percentage of participants who chose control on choice of invasive procedures. not to pursue further testing after a positive screen decreased significantly between Setting: United States 2011 and 2012, from 44% (110/250) to 32% Population: Women with a positive first (79/250) (p=0.006). Of those participants trimester screening result. who chose to pursue additional testing in A retrospective chart review was Method: 2011, 47% (117/250) chose invasive testing performed. Data were collected prior to (either CVS or amniocentesis) and only 29% (2011) and after (2012) the introduction of chose invasive testing in 2012 (p<0.001). cfDNA. Outcomes: gestational trimester at positive screen, whether cfDNA screening was requested or offered, and any additional tests pursued
() Historical control III-3 Aim: to assess changes in rates of invasive diagnostic prenatal procedures associated with combined first trimester screening and cfDNA Setting: Australia Population: invasive procedures claimed through Medicare from 1994 to 2014 Method: analysis of data from the Medicare Australia Medical Benefits Scheme (MBS) database on procedural item numbers 16600 (diagnostic amniocentesis) and 16603 (chorionic villus sampling [CVS] by any route) for the period 1994 to 2014 inclusive, by calendar year Outcomes: changes in of invasive diagnostic tests Following the introduction of the number of amniocenteses performed in Australia fell by 51% between the first quarter of 2013 and the final quarter of 2014 (1,560 vs 758. OR 0.48; 95% CI: 0.44–0.53; 2 = 282, P<0.005). The total number of CVS fell by 37% over the same period (767 vs 481. OR 0.63; 95% CI: 0.56–0.70; 2 = 66, P<0.005). This represents the largest annual decrease in invasive procedures during the 20-year study period. This change has important implications for training in, and maintenance of, the procedural skills of amniocentesis and CVS. () Historical control III-3 500 Aim: To assess the impact of cfDNA testing on choice of invasive procedures. Setting: United States Population: Women with a positive first trimester screening result. Method: A retrospective chart review was performed. Data were collected prior to (2011) and after (2012) the introduction of cfDNA. Outcomes: gestational trimester at positive screen, whether cfDNA screening was requested or offered, and any additional tests pursued The percentage of participants who chose not to pursue further testing after a positive screen decreased significantly between 2011 and 2012, from 44% (110/250) to 32% (79/250) (p=0.006). Of those participants who chose to pursue additional testing in 2011, 47% (117/250) chose invasive testing (either CVS or amniocentesis) and only 29% chose invasive testing in 2012 (p<0.001).
cfDNA%20testing%20evidence%20evaluation%2016May17.docx