{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T09:30:53Z","timestamp":1778491853575,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2013,3,1]],"date-time":"2013-03-01T00:00:00Z","timestamp":1362096000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Med Screen"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate improvements to four antenatal screening tests for Down's syndrome (first trimester Combined, second trimester Quadruple, and first and second trimester Integrated and Serum Integrated tests) based on adding ductus venosus pulsatility index (DVPI), fetal nasal bone examination (NBE) and serum placental growth factor (PlGF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Statistical analysis of data from several sources modelled using the maternal age distribution of live births in England and Wales from 2006 to 2008.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Monte Carlo simulation carried out to estimate the screening performance of tests with the addition of combinations of DVPI, NBE and PlGF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At a 95% detection rate (DR), with first trimester markers measured at 11 completed weeks\u2019 gestation, the addition of DVPI, NBE and PlGF decreased the false-positive rate (FPR) of the Combined test from 16.1% to 3.0%, the addition of PlGF to the Quadruple test decreased the FPR from 15.7% to 15.3%, the addition of DVPI, NBE and PlGF to the Integrated test decreased the FPR from 4.1% to 0.6% and the addition of PlGF to the Serum Integrated test decreased the FPR from 15.1% to 11.1%. At a 90% detection rate, the reductions in the FPR were from 6.8% to 0.8%, 7.7% to 7.4%, 1.2% to 0.1% and 6.2% to 4.8%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The addition of DVPI, NBE and PlGF to the Combined and Integrated tests significantly improves screening performance, reducing the FPRs by over 80%. The Integrated test with DVPI, NBE and PlGF is significantly better than the Combined test with DVPI, NBE and PlGF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0969141313476496","type":"journal-article","created":{"date-parts":[[2013,7,8]],"date-time":"2013-07-08T18:11:05Z","timestamp":1373307065000},"page":"7-14","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Improvements in antenatal screening for Down's syndrome"],"prefix":"10.1177","volume":"20","author":[{"given":"N J","family":"Wald","sequence":"first","affiliation":[{"name":"FRS, Professor and Institute Director, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Charterhouse Square, London EC1M 6BQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J P","family":"Bestwick","sequence":"additional","affiliation":[{"name":"Lecturer in Medical Statistics, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Charterhouse Square, London EC1M 6BQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W J","family":"Huttly","sequence":"additional","affiliation":[{"name":"Antenatal Screening Manager, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Charterhouse Square, London EC1M 6BQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,5,13]]},"reference":[{"key":"MSC476496C1","doi-asserted-by":"publisher","DOI":"10.1258\/jms.2009.009043"},{"key":"MSC476496C2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.992"},{"key":"MSC476496C3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0046955"},{"key":"MSC476496C4","doi-asserted-by":"publisher","DOI":"10.1258\/jms.2010.009107"},{"key":"MSC476496C5","doi-asserted-by":"publisher","DOI":"10.1177\/096914130301000202"},{"key":"MSC476496C6","doi-asserted-by":"publisher","DOI":"10.1258\/096914106776179872"},{"key":"MSC476496C7","doi-asserted-by":"publisher","DOI":"10.1002\/pd.840"},{"key":"MSC476496C8","volume-title":"Birth statistics. 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