Figure.

Cost effectiveness of screening strategies for Down's syndrome with a risk of 1 in 300 as cut-off point for positive result. The continuous line is the efficiency frontier. Gradient represents the additional cost incurred per additional birth prevented of an affected baby by adopting a more effective strategy (compared with next cheapest strategy). Strategies above the efficiency frontier are dominated (more costly and less effective than nuchal translucency measurement or integrated test) or ruled out by extended dominance (more costly or less effective and resulted in higher costs per prevented birth than a more effective option).¹³