Fitting observed and theoretical choices – women's choices about prenatal diagnosis of Down syndrome


  • Valerie Seror

    Corresponding author
    1. INSERM, Research Unit 379, ‘Social Sciences Applied to Medical Innovation’, Marseille F-13000, France
    2. Aix Marseille University, Marseille F-13000, France
    • INSERM, Research Unit 379, ‘Social Sciences Applied to Medical Innovation’, BP 156, 232 boulevard Sainte Marguerite, 13273 Marseille cedex 9, France
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Choices regarding prenatal diagnosis of Down syndrome – the most frequent chromosomal defect – are particularly relevant to decision analysis, since women's decisions are based on the assessment of their risk of carrying a child with Down syndrome, and involve tradeoffs (giving birth to an affected child vs procedure-related miscarriage). The aim of this study, based on face-to-face interviews with 78 women aged 25–35 with prior experience of pregnancy, was to compare the women' expressed choices towards prenatal diagnosis with those derived from theoretical models of choice (expected utility theory, rank-dependent theory, and cumulative prospect theory). The main finding obtained in this study was that the cumulative prospect model fitted the observed choices best: both subjective transformation of probabilities and loss aversion, which are basic features of the cumulative prospect model, have to be taken into account to make the observed choices consistent with the theoretical ones. Copyright © 2007 John Wiley & Sons, Ltd.