Clinical question: What is the diagnostic value and effectiveness of the following screening methods in identifying clinically important genotypes of sickle cell disease and sickle cell carrier status (trait) including: history taking; family origin; full blood count: Hb electrophoresis; ferritin; mean cell volume; high performance liquid chromatography; sickle solubility testing (Sickledex)?

StudyRef.PopulationInterventionOutcomesResultsCommentsStudy typeEL
Chasen et al., 1999711Pregnant women

Sample n = 631
Diagnostic accuracy of Hb electrophoresis with selective use of Hb electrophoresis following sickle cell solubility testing and investigation of red blood cell indices.Sickle cell diseaseSensitivity 88.9% (32/36) and specificity 79.4% (473/595) for the selective screening model. Positive predictive value = 20.8%
Negative predictive value = 99.2%.
USADiagnostic accuracyIII
Women’s views and experiences of antenatal screening for sickle cell disease/trait
StudyRef.PopulationInterventionOutcomesResultsCommentsStudy typeEL
Durosinmi et al., 1997723Well-educated, city- dwelling Nigerians, aged 15–50 years.

Sample n = 433(n = 204 males)
Investigation of views of antenatal diagnosis.Acceptability of antenatal diagnosis of sickle cell disease.78% of respondents felt antenatal sickle cell diagnosis should be available. 45% reported that they would decide to terminate a baby affected with sickle cell disease.
Cross-tabulations showed that neither religion nor educational level significantly affected a person’s decision whether or not to terminate an affected pregnancy.
NigeriaInterview-based descriptive study.3

From: Evidence tables

Cover of Antenatal Care
Antenatal Care: Routine Care for the Healthy Pregnant Woman.
NICE Clinical Guidelines, No. 62.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2008 Mar.
Copyright © 2008, National Collaborating Centre for Women’s and Children’s Health.

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