7 research outputs found
Invasive Prenatal Diagnostic Testing Recommendations are Influenced by Maternal Age, Statistical Misconception and Perceived Liability
Funding policy and medico-legal climate are part of physiciansâ reality and might permeate clinical decisions. This study evaluates the influence of maternal age and government funding on obstetrician/gynecologist recommendation for invasive prenatal testing (i.e. amniocentesis) for Down syndrome (DS), and its association with the physicianâs assessment of the risk of liability for medical malpractice unless they recommend amniocentesis. Israeli physicians (N = 171) completed a questionnaire and provided amniocentesis recommendations for women at 18 weeks gestation with normal preliminary screening results, identical except aged 28 and 37. Amniocentesis recommendations were reversed for the younger (âyesâ regardless of testing results: 6.4%; ânoâ regardless of testing results: 31.6%) versus older woman (âyesâ regardless of testing results: 40.9%; ânoâ regardless of testing results: 7.0%; Ï2 = 71.55, p < .01). About half of the physicians endorsed different recommendations per scenario; of these, 65.6% recommended amniocentesis regardless of testing results for the 37-year-old woman. Physicians routinely performing amniocentesis and those advocating for amniocentesis for all women â„ age 35 were approximately twice as likely to vary their recommendations per scenario. Physicians who perceived risk of liability for malpractice as large were nearly one-and-a-half times more likely to vary recommendations. The results indicate physiciansâ recommendations are influenced by maternal age, though age is already incorporated in prenatal DS risk evaluations. The physicianâs assessment of the risk that they will be sued unless they recommend amniocentesis may contribute to this spurious influence