Screening for Down's syndrome: effects, safety, and cost effectiveness of first and second trimester strategiesCommentary: Results may not be widely applicableAuthors' response

The choice of screening strategy should be between the integrated test, first trimester combined test, quadruple test, or nuchal translucency measurement depending on how much service providers are willing to pay, the total budget available, and values on safety. Screening based on maternal age, the second trimester double test, and the first trimester serum test was less effective, less safe, and more costly than these four options.