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Performance of Prenatal Screening Tests

enhanced First Trimester Screening (eFTS) and Second Trimester Screening (STS) performance for singleton pregnancies* 
Screening ModalityChromosome DifferenceSensitivity (Detection Rate)
% (95% CI)
False Positive Rate
% (95% CI)

eFTS

Trisomy 21

89.02 (86.68, 91.08)

6.34 (6.25, 6.43)

STS Trisomy 21

78.95 (66.11, 88.62)

5.80 (5.52, 6.09)

eFTS Trisomy 18

84.98 (79.73, 89.31)

0.26 (0.24, 0.28)

STS Trisomy 18

S (33.38, 88.18)Ψ

0.58 (0.49, 0.68)

 *Notes

  1. Data were extracted from the BORN Information System (BIS) on 1 Feb, 2022, using cytogenetic testing data with results reported up to June 30, 2021. Note that data submission to the BIS is both voluntary and open to updates and amendments. This table represents a snapshot of the BIS on the date of data extraction.
  2. The cohort timeline was defined by infant estimated date of delivery (EDD) (01-Sep-2016 to 31-Mar-2021). 
  3. S = point estimate suppressed when confidence interval >20%.
  4. Ψ = performance data have a confidence interval greater than 20%. These performance metrics were calculated using small cell sizes from the available Multiple Marker Screening and cytogenetic data in the BIS and are subject to change as more data are collected. Please interpret these data with caution.
  5. Only singleton pregnancies were included in this analysis.
  6. Only pregnancies with a valid MMS result and cytogenetic result were included in this analysis. Outcome data were supplemented using clinical examination data from the BIS for negative results for T21, and 18 when cytogenetic results were missing.
  7. "eFTS" includes both "4-marker eFTS" and "5-marker eFTS".
  8. The screen-positive cut-off for STS for trisomy 21 changed over the timeline of this analysis from 1/200 before April 2020 to 1/350 after April 2020. A screen positive result is defined by whether the result was positive based on the cut-off value established at the time of screening

Detection rate = the proportion of pregnancies that are flagged as  "screen positive" by this test and the baby really does have the chromosome difference.

False positive rate =  the proportion of pregnancies that this test will flag as "screen positive" but the baby does not really have the chromosome difference.

 

NIPT performance for singleton pregnancies with a screen from LifeLabs or Dynacare (OHIP-funded and private-pay)*
Chromosome DifferenceSensitivity (Detection Rate)
% (95% CI)
False Positive Rate
% (95% CI)
Positive Predictive Value
% (95% CI)
Negative Predictive Value
% (95% CI)
Trisomy 21

99.49 (98.82, 99.84)

0.07 (0.05, 0.09)

95.71 (94.28, 96.86)

99.99 (99.98, 100.00)

Trisomy 18

95.96 (92.48, 98.14)

0.03 (0.02, 0.04)

92.64 (88.48, 95.65)

99.99 (99.97, 99.99)

Trisomy 13

92.11 (83.60, 97.05)

0.04 (0.02, 0.06)

71.43 (61.42, 80.10)

99.99 (99.98, 100.00)

NIPT performance for singleton pregnancies with a screen from LifeLabs or Dynacare (OHIP-funded only)*
Chromosome DifferenceSensitivity (Detection Rate)
% (95% CI)
False Positive Rate
% (95% CI)
Positive Predictive Value
% (95% CI)
Negative Predictive Value
% (95% CI)
Trisomy 21

99.55 (98.85, 99.88)

0.10 (0.07, 0.13)

95.76 (94.24, 96.97)

 99.99 (99.97, 100.00)
Trisomy 18

95.54 (91.71, 97.94)

0.03 (0.02, 0.05)

93.69 (89.45, 96.60)

 99.98 (99.96, 99.99)
Trisomy 13

92.42 (83.20, 97.49)

0.05 (0.03, 0.08)

73.49 (62.66, 82.58)

 99.99 (99.97, 100.00)
 *Notes
  1. Data were extracted from the BORN Information System (BIS) on 1 Feb, 2022, using cytogenetic testing data with results reported up to June 30, 2021. Note that data submission to the BIS is both voluntary and open to updates and amendments. This table represents a snapshot of the BIS on the date of data extraction.
  2. The cohort timeline was defined by infant estimated date of delivery (EDD) (01-Sep-2016 to 31-Mar-2021). 
  3. Only singleton pregnancies were included in this analysis.
  4. Only pregnancies with a valid NIPT  result and cytogenetic result were included in this analysis. Outcome data were supplemented using clinical examination data from the BIS for negative results for T21, and 18 when cytogenetic results were missing

Detection rate = the proportion of pregnancies that are flagged as  "high risk" by this test and the baby really does have the chromosome difference.

False positive rate =  the proportion of pregnancies that this test will flag as "high risk" but the baby does not really have the chromosome difference.

Positive predictive value  = what proportion of pregnancies with a "high risk" screening result do have the chromosome difference? In other words, how accurate are the "high results"?  A "high risk" result in a high risk population (e.g. screen positive eFTS, ultrasound abnormalities) is more likely to be a true result than a "high risk" screening result in a low risk population.

Negative predictive value   = what proportion pregnancies with a "low risk" screening result truly do not have the chromosome difference?  In other words, how accurate are the "low risk results"?

Performance of Prenatal Screening System: The Basics

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WHAT

The aim of this analysis was to measure the performance of Ontario's prenatal screening system for the detection of trisomy 21 and trisomy 18.

 

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WHY

Evaluating real-world prenatal screening system performance is important for making improvements to the system, and facilitating decision making for pregnant individuals.

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WHO

Singleton pregnancies with an estimated due date between September 1, 2016 and March 31, 2021 who underwent publicly funded and/or private-pay prenatal screening.

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HOW

The analysis examined routinely collected data from BORN Ontario, the province's perinatal registry. BORN Ontario collects critical health data about every pregnancy, birth and newborn in Ontario. 

Do you need further information to understand the language used in research studies?

Institute for Health and Work Research - What Researchers Mean by... - More than 35 common research terms used in the health and social sciences are covered on this website, each explained in simple language using everyday examples

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