Non-invasive prenatal testing and the unveiling of an impaired translation process

Authors

Blake Murdoch, University of Alberta, Canada
Vardit Ravitsky, University of Montreal, Canada
Ubaka Ogbogu, University of Alberta, Canada
Sarah Ali-Khan, McGill University, Canada
Gabrielle Bertier, McGill University, Canada
Stanislav Birko, University of Montreal, Canada
Tania M. Bubela, University of Alberta, CanadaFollow
Jeremy De Beer, University of Ottawa, Canada
Charles Dupras, University of Montreal, Canada
Meika Ellis, University of Alberta, Canada

Document Type

Article

Department

Office of the Provost

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.

Comments

This work was published before Tania joined Aga Khan University.

Publication (Name of Journal)

Journal of Obstetrics and Gynaecology Canada

DOI

10.1016/j.jogc.2016.09.004

Recommended Citation

Murdoch, B., Ravitsky, V., Ogbogu, U., Ali-Khan, S., Bertier, G., Birko, S., Bubela, T. M., De Beer, J., Dupras, C., Ellis, M. (2017). Non-invasive prenatal testing and the unveiling of an impaired translation process. Journal of Obstetrics and Gynaecology Canada, 39(1), 10-17.
Available at: https://ecommons.aku.edu/provost_office/750