Evidence map›Paper›PMID 33724493›Full record

ArticlePrenatal diagnosis2021

Dealing with uncertain results from chromosomal microarray and exome sequencing in the prenatal setting: An international cross-sectional study with healthcare professionals.

Celine Lewis, Jennifer Hammond, Jasmijn E Klapwijk, Eleanor Harding, Stina Lou, Ida Vogel, Emma J Szepe, Lisa Hui, Charlotta Ingvoldstad-Malmgren, Maria J Soller and 4 more

Abstract read
In one paragraph

Article in Prenatal diagnosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Celine LewisPopulation, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK.ORCID https://orcid.org/0000-0001-7169-1521
Jennifer HammondNorth Thames Genomic Laboratory Hub, Great Ormond Street Hospital, London, UK.
Jasmijn E KlapwijkDepartment of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands.
Eleanor HardingBSc Paediatrics and Child Health, The UCL Great Ormond Street Institute of Child Health, London, UK.
Stina LouCenter for Fetal Diagnostics, Aarhus University Hospital, Aarhus, Denmark.
Ida VogelCenter for Fetal Diagnostics, Aarhus University Hospital, Aarhus, Denmark.
Emma J SzepeReproductive Epidemiology, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Lisa HuiDepartment of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.ORCID https://orcid.org/0000-0002-9720-3562
Charlotta Ingvoldstad-MalmgrenCenter for Fetal Medicine, Karolinska University Hospital, Stockholm, Sweden.
Maria J SollerDepartment of Clinical Genetics, Karolinska Hospital and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Kelly E OrmondDepartment of Genetics and Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California, USA.
Mahesh ChoolaniDepartment of Obstetrics & Gynaecology, National University Hospital, Singapore.ORCID https://orcid.org/0000-0001-8336-0973
Melissa HillNorth Thames Genomic Laboratory Hub, Great Ormond Street Hospital, London, UK.ORCID https://orcid.org/0000-0003-3900-1425
Sam RiedijkDepartment of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands.

Funding

Wellcome TrustWellcome Trust 211288/Z/18/Z
6 · The paper itself

Abstract

objectivesTo conduct qualitative interviews with healthcare providers working in different countries to understand their experiences of dealing with uncertain results from prenatal chromosome microarray analysis (CMA) and exome sequencing (ES).

methodsSemi-structured interviews with 31 healthcare providers who report or return prenatal CMA and/or ES results (clinicians, genetic counsellors and clinical scientists) in six countries with differing healthcare systems; Australia (4), Denmark (5), Netherlands (6), Singapore (4), Sweden (6) and United Kingdom (6). The topic guide explored the main sources of uncertainty and their management.

resultsThere was variation in reporting practices both between and across countries for variants of uncertain significance, however, there was broad agreement on reporting practices for incidental findings. There was also variation in who decides what results are reported (clinical scientists or clinicians). Technical limitations and lack of knowledge (to classify variants and of prenatal phenotypes) were significant challenges, as were turnaround times and lack of guidelines.

conclusionHealth professionals around the globe are dealing with similar sources of uncertainty, but managing them in different ways, Continued dialogue with international colleagues on ways of managing uncertain results is important to compare and contrast the benefits and limitations of the different approaches.

Indexed as

UncertaintyAdultAustraliaCross-Sectional StudiesDenmarkExome SequencingFemaleHealth PersonnelHumansInterviews as TopicMicroarray AnalysisNetherlandsPregnancyPrenatal CareSingaporeSweden

Identifiers

PMID33724493
PMCPMC8519283

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.