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Computerized prenatal genetic testing decision-assisting tool: a randomized controlled trial.

Abstract：

OBJECTIVE: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. METHODS: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. RESULTS: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). CONCLUSION:Using an interactive prenatal testing decision tool results in more informed prenatal genetic testing decisions than viewing standard educational booklets. CLINICAL TRIAL REGISTRATION:Clinicaltrials.gov, www.clinicaltrials.gov, NCT00686062 LEVEL OF EVIDENCE:I.

journal_name

Obstet Gynecol

journal_title

Obstetrics and gynecology

authors

Kuppermann M,Norton ME,Gates E,Gregorich SE,Learman LA,Nakagawa S,Feldstein VA,Lewis J,Washington AE,Nease RF Jr

doi

10.1097/AOG.0b013e31818e7ec4

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

53-63

issue

eissn

0029-7844

issn

1873-233X

pii

00006250-200901000-00011

journal_volume

113

pub_type

杂志文章,随机对照试验

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Computerized prenatal genetic testing decision-assisting tool: a randomized controlled trial.