α-Fetoprotein Screening and the Standard of Care-Reply

In Reply.—  The survey that was the basis of this study was performed in April 1985, a fact that was regrettably removed from the original manuscript in the editing process. I share Dr Weiss' surprise that only 15% of plans surveyed at the time were routinely offering serum α-fetoprotein screening. Our group model health maintenance organization (NorthCare Medical Group/PruCare of Illinois) reached the same conclusion as Dr Weiss—that serum α-fetoprotein screening should be routinely offered to all patients—and it has offered such screening for several years.Nonetheless, I am uncomfortable in declaring serum α-fetoprotein screening to be "the standard of care," particularly when less than two years ago only 15% of groups routinely offered this test. Neither the current editions of Williams' Obstetrics¹ nor Danforth's and Scott's Obstetrics and Gynecology² recommend that this test be done routinely. Based on my informal knowledge of medical group practices throughout the