{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T02:25:41Z","timestamp":1780367141566,"version":"3.54.1"},"reference-count":47,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2016,9,14]],"date-time":"2016-09-14T00:00:00Z","timestamp":1473811200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004572","name":"National Health and Family Planning Commission of the People's Republic of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004572","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Controversies about the performance of conventional prenatal screening using maternal serum and ultrasound markers (<jats:styled-content style=\"fixed-case\">PSMSUM<\/jats:styled-content>) in detecting Down syndrome (<jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content>) have been raised as a result of a recently available noninvasive prenatal test based on cell\u2010free fetal <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> sequencing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the screening performance of <jats:styled-content style=\"fixed-case\">PSMSUM<\/jats:styled-content> in detecting <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> in Chinese women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>An exhaustive literature search of <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>, Embase, the Cochrane Library, <jats:styled-content style=\"fixed-case\">ISI<\/jats:styled-content> Web of Science and China BioMedical Disc.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>Primary studies, published from January 2004 to November 2014, which examined the screening accuracy of <jats:styled-content style=\"fixed-case\">PSMSUM<\/jats:styled-content> in pregnant Chinese women, compared with a reference standard, either chromosomal verification or inspection of the newborn.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Data were extracted as screening positive\/negative results for Down and non\u2010Down syndrome pregnancies, allowing estimation of sensitivities and specificities. Risks of bias within and across studies were assessed. Screening accuracy measures were pooled using a bivariate random effects regression model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Seventy\u2010eight studies, involving six categories of <jats:styled-content style=\"fixed-case\">PSMSUM<\/jats:styled-content>, were included. Second\u2010trimester double serum [pooled sensitivity (<jats:styled-content style=\"fixed-case\">SEN<\/jats:styled-content>) = 0.80, pooled specificity (<jats:styled-content style=\"fixed-case\">SPE<\/jats:styled-content>) = 0.95] and triple\u2010serum (pooled <jats:styled-content style=\"fixed-case\">SEN<\/jats:styled-content> = 0.79, pooled <jats:styled-content style=\"fixed-case\">SPE<\/jats:styled-content> = 0.96) screening were the predominant <jats:styled-content style=\"fixed-case\">PSMSUM<\/jats:styled-content> methods. The screening performances of these methods achieved the national standard but varied enormously across studies. First\u2010trimester combined screening (pooled <jats:styled-content style=\"fixed-case\">SEN<\/jats:styled-content> = 0.92, pooled <jats:styled-content style=\"fixed-case\">SPE<\/jats:styled-content> = 0.93) and second\u2010trimester quadruple serum screening (median <jats:styled-content style=\"fixed-case\">SEN<\/jats:styled-content> = 0.86, median <jats:styled-content style=\"fixed-case\">SPE<\/jats:styled-content> = 0.96) performed better, but were rarely used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Author's conclusions<\/jats:title><jats:p>Second\u2010trimester maternal serum screening has the potential to achieve satisfactory screening performance in middle\u2010 and low\u2010income countries. The reported enormous range in screening performance of second\u2010trimester <jats:styled-content style=\"fixed-case\">PSMSUM<\/jats:styled-content> calls for urgent implementation of methods for performance optimization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Meta\u2010analysis results show good accuracy of maternal serum and ultrasound screening for trisomy 21 in Chinese women.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14009","type":"journal-article","created":{"date-parts":[[2016,9,14]],"date-time":"2016-09-14T15:05:30Z","timestamp":1473865530000},"page":"12-22","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Performance of prenatal screening using maternal serum and ultrasound markers for Down syndrome in Chinese women: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"123","author":[{"given":"S","family":"Tu","sequence":"first","affiliation":[{"name":"Key Lab of Health Technology Assessment Ministry of Health (Fudan University) School of Public Health Fudan University Shanghai China"},{"name":"Collaborative Innovation Centre of Social Risks Governance in Health School of Public Health Fudan University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Harvard T. H. Chan School of Public Health Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Wang","sequence":"additional","affiliation":[{"name":"Key Lab of Health Technology Assessment Ministry of Health (Fudan University) School of Public Health Fudan University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Huang","sequence":"additional","affiliation":[{"name":"Key Lab of Health Technology Assessment Ministry of Health (Fudan University) School of Public Health Fudan University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Chen","sequence":"additional","affiliation":[{"name":"Key Lab of Health Technology Assessment Ministry of Health (Fudan University) School of Public Health Fudan University Shanghai China"},{"name":"Collaborative Innovation Centre of Social Risks Governance in Health School of Public Health Fudan University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,9,14]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20409"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm.2011.671"},{"key":"e_1_2_13_4_1","first-page":"CD009925","article-title":"Second trimester serum tests for Down's syndrome screening","volume":"6","author":"Alldred SK","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_5_1","unstructured":"MariaO KenB CarmenM AndersonC CharlesY ThanhN et\u00a0al.First and second trimester prenatal screening for trisomies 13 18 and 21 and open neural tube defects.Edmonton:Institute of Health Economics;2011."},{"key":"e_1_2_13_6_1","unstructured":"O'ConnellR StephensonM WeirR.Screening strategies for antenatal Down syndrome screening: a systematic review of the literature. New Zealand health technology assessment report.Christchurch:Christchurch School of Medicine and Science Department of Public Health and General Practice;2006November. Report No.: NZHTA Report 2006; 9."},{"key":"e_1_2_13_7_1","unstructured":"EUROCAT Central Registry.Special report: prenatal screening policies in Europe.Newtownabbey Co. Antrim Northern Ireland:EUROCAT;2010."},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)34961-1"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200701000-00054"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000058"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.811"},{"key":"e_1_2_13_12_1","unstructured":"Ministry of Health.Regulation of prenatal diagnostic technology (in Chinese) Order No. 33.China:Ministry of Health China;2002."},{"key":"e_1_2_13_13_1","first-page":"42","article-title":"Technical standards of prenatal screening and diagnosis for fetal common chromosomal abnormalities and open neural tube defects: part 1. Maternal serum prenatal screening in second trimester (in Chinese)","volume":"3","author":"Bian X","year":"2011","journal-title":"Chinese J Prenatal Diagn"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3724\/SP.J.1008.2014.00089"},{"key":"e_1_2_13_15_1","unstructured":"Department of Maternal and Child Health in National Health and Family Planning Commission of PRC.Technical standards of high\u2010throughput sequencing prenatal test and diagnosis (trial implementation).Beijing China:Department of Maternal and Child Health in National Health and Family Planning Commission of PRC;2015."},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2013.10.003"},{"key":"e_1_2_13_17_1","first-page":"208","article-title":"Bibliometric analysis on the prenatal screening and diagnosis of Down's syndrome in China (in Chinese with English abstract)","volume":"29","author":"Chen Y","year":"2013","journal-title":"Chinese J Practical Gynecol Obstet"},{"key":"e_1_2_13_18_1","first-page":"2313","article-title":"Systematic evaluation of dual\u2010marker in the second trimester for screening of Down's syndrome in Chinese (in Chinese with English abstract)","volume":"5","author":"Wu J","year":"2011","journal-title":"Chinese J Clinicians"},{"key":"e_1_2_13_19_1","volume-title":"Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy Version 10","author":"Macaskill P"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_13_21_1","unstructured":"YingyaoC.Study on disease burdens of main birth defects and economic evaluation of their preventive interventions in China[PhD thesis].Shanghai China:Fudan University;2006."},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00009"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1258\/096914103321824133"},{"key":"e_1_2_13_24_1","unstructured":"The Nordic Cochrane Centre.Review Manager (RevMan).Copenhagen:The Cochrane Collaboration;2014."},{"key":"e_1_2_13_25_1","unstructured":"DwamenaB.Midas: a program for meta\u2010analytical integration of diagnostic accuracy studies in Stata.Ann Arbor Michigan:Division of Nuclear Medicine Department of Radiology University of Michigan Medical School;2007."},{"key":"e_1_2_13_26_1","unstructured":"Stata Corp.Stata statistical software release 14.College Station TX:StataCorp LP.;2015."},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2005.02.022"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1099"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-2-9"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-6-31"},{"key":"e_1_2_13_32_1","first-page":"8","article-title":"Prenatal screening and diagnosis results for 4,954 cases with high risk of being affected by Down's syndrome (in Chinese)","volume":"53","author":"Hu B","year":"2009","journal-title":"Chinese J Birth Health Hered"},{"key":"e_1_2_13_33_1","first-page":"24","article-title":"Using AFP and free\u2010\u03b2\u2010HCG to screen Down's syndrome in second trimester (in Chinese)","volume":"14","author":"Lv W","year":"2006","journal-title":"Chinese J Birth Health Hered"},{"key":"e_1_2_13_34_1","first-page":"750","article-title":"Study on alpha\u2010fetoprotein and free \u03b2\u2010human chorionic gonadotropin assays for screening Down's syndrome fetuses in 44 566 pregnant women (in Chinese with English abstract)","volume":"24","author":"Chen Y","year":"2013","journal-title":"Chinese J Woman Child Health Res"},{"key":"e_1_2_13_35_1","first-page":"87","article-title":"Validity of different methods to prenatal screening for Down's syndrome during first and second trimester pregnancy of Chinese\u2010women","volume":"26","author":"Yang F","year":"2013","journal-title":"Biomed Environ Sci"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2412"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043693"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta7110"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e318160f274"},{"key":"e_1_2_13_40_1","unstructured":"GuoQ.Comparison of different serum screening tests for aneupolyhaploid in second\u2010trimester of pregnancy(in Chinese with English abstract) [Dissertation].Beijing China:Peking Union Medical College;2008."},{"key":"e_1_2_13_41_1","unstructured":"LiY.The cloning and expression of INHIBIN preparation and identification of McAbs(in Chinese with English abstract) [Master].Guangdong China:Southern Medical University;2009."},{"key":"e_1_2_13_42_1","first-page":"101","article-title":"Prospective assessment of the Hong Kong Hospital Authority universal Down syndrome screening programme","volume":"19","author":"Sahota DS","year":"2013","journal-title":"Hong Kong Med J"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767050802430842"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3893"},{"key":"e_1_2_13_45_1","first-page":"574","article-title":"Guideline of prenatal ultrasound tests (2012) (in Chinese)","volume":"09","author":"Li S","year":"2012","journal-title":"Chinese J Medical Ultrasound"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-3782(96)01820-8"},{"key":"e_1_2_13_47_1","unstructured":"School of Public Health Fudan University 2012 Leeds University Leeds"},{"key":"e_1_2_13_48_1","unstructured":"GuE.Effectiveness evaluation of screening of Down syndrome in China(in Chinese with English abstract) [Masters].Shanghai China:Fudan University;2010."}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.14009","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.14009","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.14009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T23:12:32Z","timestamp":1694646752000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.14009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9]]},"references-count":47,"journal-issue":{"issue":"S3","published-print":{"date-parts":[[2016,9]]}},"alternative-id":["10.1111\/1471-0528.14009"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.14009","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,9]]},"assertion":[{"value":"2016-02-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-09-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}