AUTHOR=Chaipongpun Nitchanut , Wanapirak Chanane , Sirichotiyakul Supatra , Tongprasert Fuanglada , Srisupundit Kasemsri , Luewan Suchaya , Traisrisilp Kuntharee , Jatavan Phudit , Sirilert Sirinart , Tongsong Theera 

TITLE=Performance of Serum Quad Test in Screening for Fetal Down Syndrome in a Large-Scale Unselected Population in a Developing Country

JOURNAL=International Journal of Public Health

VOLUME=68

YEAR=2023

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2023.1605441

DOI=10.3389/ijph.2023.1605441

ISSN=1661-8564

ABSTRACT=<p><bold>Objective:</bold> To assess the effectiveness of Quad test in the detection of Down syndrome (DS) in routine practice among a large-scale population and to compare the effectiveness of Quad test based on the Western reference model (WM) and that based on Thai reference model (TM).</p><p><bold>Methods:</bold> Quad test was performed on 42,769 pregnancies at 14–21 weeks. The fetal risk of DS derived from Quad test was automatically computed based on WM and used in evaluating the effectiveness. Also, the fetal risk was calculated based on the TM.</p><p><bold>Results:</bold> Of 39,740 women with complete follow-ups including 74 fetuses with DS, with WM, the detection and false positive rates were 81.1% and 7.2%, respectively, whereas the detection and false positive rates with TM were 87.8%, and 6.8%, respectively. According to ROC curves, the performance of Quad test based on TM was slightly but significantly better than that based on WM (AUC of 0.959 vs. 0.940, <italic>p</italic> = 0.001).</p><p><bold>Conclusion:</bold> Quad test is highly effective in service settings and suitable for developing countries and the effectiveness is even higher when based on ethnicity-specific reference model.</p>