Title |
Non-invasive Prenatal Testing and the Unveiling of an Impaired Translation Process
|
---|---|
Published in |
Journal of obstetrics and gynaecology Canada JOGC Journal d obstétrique et gynécologie du Canada JOGC, October 2016
|
DOI | 10.1016/j.jogc.2016.09.004 |
Pubmed ID | |
Authors |
Blake Murdoch, Vardit Ravitsky, Ubaka Ogbogu, Sarah Ali-Khan, Gabrielle Bertier, Stanislav Birko, Tania Bubela, Jeremy De Beer, Charles Dupras, Meika Ellis, Palmira Granados Moreno, Yann Joly, Kalina Kamenova, Zubin Master, Alessandro Marcon, Mike Paulden, François Rousseau, Timothy Caulfield |
Abstract |
Non-invasive prenatal testing (NIPT) is an exciting technology with the potential to provide a variety of clinical benefits, including a reduction in miscarriages, via a decline in invasive testing. However, there is also concern that the economic and near-future clinical benefits of NIPT have been overstated and the potential limitations and harms underplayed. NIPT, therefore, presents an opportunity to explore the ways in which a range of social pressures and policies can influence the translation, implementation, and use of a health care innovation. NIPT is often framed as a potential first tier screen that should be offered to all pregnant women, despite concerns over cost-effectiveness. Multiple forces have contributed to a problematic translational environment in Canada, creating pressure towards first tier implementation. Governments have contributed to commercialization pressure by framing the publicly funded research sector as a potential engine of economic growth. Members of industry have an incentive to frame clinical value as beneficial to the broadest possible cohort in order to maximize market size. Many studies of NIPT were directly funded and performed by private industry in laboratories lacking strong independent oversight. Physicians' fear of potential liability for failing to recommend NIPT may further drive widespread uptake. Broad social endorsement, when combined with these translation pressures, could result in the "routinization" of NIPT, thereby adversely affecting women's reproductive autonomy. Policymakers should demand robust independent evidence of clinical and public health utility relevant to their respective jurisdictions before making decisions regarding public funding for NIPT. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Canada | 3 | 25% |
United Kingdom | 2 | 17% |
United States | 1 | 8% |
Austria | 1 | 8% |
Unknown | 5 | 42% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 6 | 50% |
Scientists | 4 | 33% |
Practitioners (doctors, other healthcare professionals) | 2 | 17% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 54 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 12 | 22% |
Researcher | 7 | 13% |
Other | 6 | 11% |
Student > Doctoral Student | 4 | 7% |
Student > Ph. D. Student | 3 | 6% |
Other | 11 | 20% |
Unknown | 11 | 20% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 11 | 20% |
Social Sciences | 7 | 13% |
Biochemistry, Genetics and Molecular Biology | 4 | 7% |
Nursing and Health Professions | 4 | 7% |
Business, Management and Accounting | 3 | 6% |
Other | 10 | 19% |
Unknown | 15 | 28% |