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JAMA. 1990;263(2):305-306. doi:10.1001/jama.1990.03440020149048.
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"Safe" and "effective" are defined as follows: Safety is the condition of presenting a reasonably low risk of harm, injury, or loss when a technology is utilized in the specified indication; and effectiveness is the quality of producing a desired, beneficial effect under the conditions of actual use. The categories for response to a DATTA question are defined as follows: Established—this technology has been adequately evaluated, and its (A) safety or (B) effectiveness is accepted as appropriate by the practicing medical community for the given indication in the specified patient population; promising—given current knowledge, the (A) safety or (B) effectiveness of this technology appears to be appropriate for the given indication in the specified patient population; as more experience and long-term follow-up are accumulated, this interim rating will change; investigational—there is no consensus on the (A) safety or (B) effectiveness of this technology to date, there is insufficient evidence to determine its appropriateness, or it warrants further study; use of this technology for the given indication in the specified patient population should be confined largely to research protocols; doubtful—given current knowledge, the (A) safety or (B) effectiveness of this technology appears to be inappropriate for the given indication in the specified patient population; as more experience and long-term follow-up are accumulated, this interim rating will change; and unacceptable—the (A) safety or (B) effectiveness of this technology is regarded by the practicing medical community as inappropriate for the given indication in the specified patient population.
For each question, the response category receiving the most votes was tested for a majority, assuming that the DATTA panel is a sample from a broader population of experts. By using exact binomial probabilities, the likelihood of the observed vote was calculated if exactly 50% of the total population of experts support that response for that question. Hence, the null hypothesis is that 50% of all experts support the response, and the alternative hypothesis is that more than 50% of all experts support the response. Rejection of the null hypothesis, and acceptance of the alternative, is interpreted as evidence of a majority opinion in the total population of experts, and a consensus is achieved.
The vote of 34 of 46 believing the effectiveness of chorionic villus sampling is "established" has P<.0001, the null hypothesis is rejected, and a majority consensus exists that chorionic villus sampling is established as effective. The vote of 26 of 46 believing the safety of chorionic villus sampling is "established" has P =.1021, so the null hypothesis is not rejected. Combining the "established" and "promising" votes into the category "appropriate," the vote is 40 of 46. This has a P<.0001, the null hypothesis is rejected, and a majority consensus exists that the safety of chorionic villus sampling is appropriate. There were 12 panelists who had no opinion for questions A and B.
 Chorionic villus sampling . JAMA. 1987;258:3560-3563.
Link to Article[[XSLOpenURL/10.1001/jama.1987.03400240092034]]
Canadian Collaborative CVS-Amniocentesis Clinical Trial Group.  Multicentre randomized clinical trial of chorionic villus sampling and amniocentesis . Lancet. 1989;1:1-6.
Rhoads GG, Jackson LG, Schlesselman SE, et al.  The safety and efficacy of chorionic villus sampling for early prenatal diagnosis of cytogenetic abnormalities . N Engl J Med. 1989;320:609-617.
Link to Article[[XSLOpenURL/10.1056/NEJM198903093201001]]
UCLA Conference.  New frontiers in genetic medicine . Ann Intern Med. 1986;104:527-539.
Link to Article[[XSLOpenURL/10.7326/0003-4819-104-4-527]]
Jackson L. CVS Newslett . (January) 1989.
Ward RHT, Modell B, Petro M, et al.  Method of sampling chorionic villi in first trimester pregnancy under guidance of real time ultrasound . Br J Med. 1983;286:1542-1544.
Link to Article[[XSLOpenURL/10.1136/bmj.286.6377.1542]]
Wapher RJ, Jackson L.  Chorionic villus sampling . Clin Obstet Gynecol. 1988;31:328-344.
Link to Article[[XSLOpenURL/10.1097/00003081-198806000-00010]]
Wilson RD, Kendrick V, Wittmann BK, McGillivary BC.  Risk of spontaneous abortion in ultrasonically normal pregnancies . Lancet. 1984;2:920.
Link to Article[[XSLOpenURL/10.1016/S0140-6736(84)90670-6]]
Green JE, Dorfmann A, Jones SL, Bender S, Patton L, Schulman JD.  Chorionic villus sampling: experience with an initial 940 cases . Obstet Gynecol. 1988;71:208-212.
Evans MI, Drugan A, Koppitch FC, Zador IE, Sacks AJ, Sokol RJ.  Genetic diagnosis in the first trimester: the norm for the 1990s . Am J Obstet Gynecol. 1989;160:1332-1336.
Link to Article[[XSLOpenURL/10.1016/0002-9378(89)90852-1]]
Crane JP, Beaver HA, Choung SW.  First trimester chorionic villus sampling vs mid-trimester genetic amniocentesis—preliminary results of a controlled prospective trial . Prenat Diagn. 1988;8:355-366.
Link to Article[[XSLOpenURL/10.1002/(ISSN)1097-0223]]
MacKenzie WE, Holmes DS, Newton JR.  A study comparing transcervical with transabdominal chorionic villus sampling (CVS) . Br J Obstet Gynaecol. 1988;95:75-78.
Link to Article[[XSLOpenURL/10.1111/bjo.1988.95.issue-1]]
Brambati B, Lanzani A, Oldrini A.  Transabdominal chorionic villus sampling: clinical experience of 1,159 cases . Prenat Diagn. 1988;8:609-617.
Link to Article[[XSLOpenURL/10.1002/(ISSN)1097-0223]]

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