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An Evaluation of the Informed Decision Making Process Regarding NIPT

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NIPT: Who is more informed?

Introduction:

Facilitating an informed decision is considered the central objective when giving information regarding prenatal screening options (van den Berg et al., 2006). Goldberg (2009) found that informed decision making led to increased satisfaction with the patient-practitioner relationship, improved clinical outcomes and many other positive results. Despite the emphasis in the medical literature on the importance of informed decision making, its presence in many ethical guidelines, and the clear value women place on the informed decision making process, Van den Berg et al. (2006) found that 51% of women do not make informed decisions regarding prenatal screening. Additionally, concern has been raised that the ease of testing may result in rapid and uninformed decisions being made (Farrell, Agatisa, & Nutter, 2014).

Discussion:

Finding one: Involvement of a genetic counselor predicts informed decision making

When a patient met with a genetic counselor we found that they were more likely to make an informed decision than when they met with another prenatal practitioner. An OR of 3.0 or more is considered a “moderately strong” effect size in the social science field. As the effect size of a genetic counselor on the decision making process was found to be 3.37, it is clear that involvement of a genetic counselor is a predictor of whether and informed decision is made regarding NIPT.

Finding two:  Informed decision making predicts NIPT uptake

Uptake was shown to be largely predicted by whether an informed decision was made. While it is not the goal of a genetic counselor to influence the patient in any way, this finding shows us that allowing the patient to have unbiased information, non-directive counseling, and time to deliberate, they are more likely to decide to have NIPT performed. It can be concluded that if a woman is not given the opportunity to make an informed decision, it is more likely she will reject having NIPT and will not be receiving information from this screen she may want.

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