Trial reportBMJ (Clinical research ed.)1995
Antenatal screening for carriers of cystic fibrosis: randomised trial of stepwise v couple screening.
Trial report in BMJ (Clinical research ed.), 1995. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A Systematic Review of Randomized Controlled Trials to Assess Outcomes of Genetic Counseling.Journal of genetic counseling · 2017Pooled it
- Measuring informed choice in population-based reproductive genetic screening: a systematic review.European journal of human genetics : EJHG · 2015Pooled it
- Psychological interventions for individuals with cystic fibrosis and their families.The Cochrane database of systematic reviews · 2014Pooled it
- Genetic nurse counsellors can be an acceptable and cost-effective alternative to clinical geneticists for breast cancer risk genetic counselling. Evidence from two parallel randomised controlled equivalence trials.British journal of cancer · 2006Trial
- The hip trial: psychosocial consequences for mothers of using ultrasound to manage infants with developmental hip dysplasia.Archives of disease in childhood. Fetal and neonatal edition · 2005Trial
- Randomised controlled trial comparing effectiveness of touch screen system with leaflet for providing women with information on prenatal tests.BMJ (Clinical research ed.) · 2000Trial
- Cystic fibrosis carrier population screening in the primary care setting.American journal of human genetics · 1996Trial
- Adjunct prenatal testing: patient decisions regarding ethnic carrier screening and fluorescence in situ hybridization.Journal of genetic counseling · 2004Article
- Update and Review: Cystic Fibrosis.Journal of genetic counseling · 1999Article
- Attitudes toward cystic fibrosis carrier and prenatal testing and utilization of carrier testing among relatives of individuals with cystic fibrosis.Journal of genetic counseling · 1999Article
- Costs, effects, and savings of screening for cystic fibrosis gene carriers.Journal of epidemiology and community health · 1998Article
- Social and psychological issues associated with the new genetics.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 1997Review
- The uptake and acceptability to patients of cystic fibrosis carrier testing offered in pregnancy by the GP.Journal of medical genetics · 1997Article
- PCR-based screening for cystic fibrosis carrier mutations in an ethnically diverse pregnant population.American journal of human genetics · 1997Article
- Prenatal screening for carriers of cystic fibrosis should screen both partners individually.BMJ (Clinical research ed.) · 1996Article
- The views of general practitioners on community carrier screening for cystic fibrosis.The British journal of general practice : the journal of the Royal College of General Practitioners · 1996Article
- Cost effectiveness of antenatal screening for cystic fibrosis.BMJ (Clinical research ed.) · 1995Article
- Direct marketing of cystic fibrosis carrier screening: commercial push or population need?Journal of medical genetics · 1995Article
- Antenatal screening for cystic fibrosis.BMJ (Clinical research ed.) · 1995Article
- Stepwise or couple antenatal carrier screening for cystic fibrosis?: women's preferences and willingness to pay.Journal of medical genetics · 1995Article
Corrections and comments
- Commented on by
Authors and funding
9 authors.
Funding
Abstract
objectiveTo perform a rigorous comparative evaluation of stepwise and couple approaches to antenatal carrier screening for cystic fibrosis.
designPragmatic randomised trial.
settingHospital antenatal clinic serving a regional population. SUBJECTS: 2002 women (couples) attending for booking antenatal visit at less than 17 weeks' gestation with no family history of cystic fibrosis.
interventionsOffering counselling and carrier testing for cystic fibrosis, either to women in the first instance (stepwise) or to couples (couple screening).
main outcome measuresUptake rates; anxiety; knowledge of cystic fibrosis and carrier status (both partners); attitudes to health, pregnancy, the baby, and screening (both partners); and uptake of carrier testing by relatives.
resultsUptake of screening was the same for both approaches (90%). After delivery most women remembered test results and their meaning, but 53/253 (21%) of those with negative results of couple testing had forgotten that repeat testing would be advisable if they had a pregnancy with a new partner. With stepwise screening women identified as carriers had high levels of anxiety when results were received (mean anxiety score 52.3). This dissipated with a reassuring partner's result (carriers' mean anxiety score 36.1) to levels similar to those receiving negative results from couple screening. Of those receiving negative results, women who had stepwise screening were significantly less anxious than those who had couple screening (mean score with result 32.1 v 35.4, 95% confidence interval for difference -4.7 to -2.1).
conclusionsCouple screening allows carriers to avoid transient high levels of anxiety, but is associated with more anxiety and false reassurance among most screenees who will test negative. Stepwise screening gives carriers and their relatives genetic information and is, in our opinion, the better method.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.