Scientific advances:

αlpha 8 can be used for Down’s syndrome screening using first trimester placental growth factor as a marker 88. This marker was previously not available in αlpha.

αlpha 8 includes the latest statistical parameters for pre-eclampsia screening. Pre-eclampsia screening using first trimester PAPP-A, mean arterial pressure (MAP) and first and second trimester placental growth factor 89, 93, 94 is now possible. These markers were not previously available for pre-eclampsia screening.

αlpha 8 can calculate screening performance estimates for Down’s syndrome, trisomy 18, SLOS, trisomy 13 and pre-eclampsia. Previously screening performance estimates for Down’s syndrome only could be calculated. Since version 8.0.14120.22 the detection rate at a fixed false positive rate and the false positive rate for a fixed detection rate are both calculated.

αlpha 8 includes a gestation specific adjustment for inhibin-A for women who smoke. 97. Prior to version 8.0.14120.22 the adjustment factor for inhibin-A was not gestation specific.

The statistical parameters, prevalence and fetal loss rates for trisomy 18 were updated to the latest values in version 8.0.14224.26 (See Appendix L). The inhibin-A standard deviation for unaffected pregnancies was updated to the latest value for trisomy 13 (See Appendix M).

αlpha 8 includes a log-sigmoid function for the regression equation relating median nuchal translucency measurements to CRL 98. Prior to version 8.0.14224.26 the only regression equation available was log-linear.

αlpha 8 includes smoking factor adjustements for first and second trimester PlGF. Prior to version 8.0.14224.26 these adjustment factors were not applied.

αlpha 8 allows the categorical measurement of ductus venosus blood flow from the second fetus in a twin pregnancy to be included in Down’s syndrome risk estimate. Prior to version 8.0.14224.26 this was only used in singleton pregnancies.

αlpha version 8.0.14273.29 includes options to show cumulative sum (CUSUM) plots, plots of standard positive rate by month and plots of MoMs with confidence intervals by smoking status, diabetes status and ethnicity.

αlpha version 8.0.14273.29 includes an option to make factor adjustments to median equations.

αlpha version 8.0.15049.39 includes an option to derive the gestational age for a twin pregnancy from the larger two of the two CRL measurements in addition to the current method which uses the average of the two CRL measurements. This was extended to include HC measurements in version 8.0.15077.41

αlpha version 8.0.15077.41 includes an option to show fetus specific risks in a twin pregnancy if only NT measurements are provided.

αlpha version 8.0.15126.42 uses updated values for the prevalence of Down’s syndrome in twin pregnancies 99. Previously, the prevalence of Down’s syndrome in twin pregnancies was taken to be the same as in singleton pregnancies.

αlpha version 8.0.15230.49 allows screening interpretations to be made for trisomy 18 and trisomy 13 when screening for Down’s syndrome. Previously pregnancies at high risk of trisomy 18 or trisomy 13 were identified as an incidental result of screening for Down’s syndrome. Individual risk cut-offs can be specified for Down’s syndrome, trisomy 18 and trisomy 13, a single risk cut-off for trisomy 18 or trisomy 13, or a single risk cut-off for all three trisomies 100.

αlpha version 8.0.15258.52 implements the reflex DNA screeing protocol 103, 104 and also implements sequential integrated screening for trisomy 18 and trisomy 13 102.

Technical advances:
αlpha 8 contains many advances which improve ease of use and user friendliness:

•  Simpler navigation:

-All features are grouped into one of three sections – Patients, Statistics and Setup
-Easy to switch from one feature to another and back again. You can return to the first feature and carry on from exactly where you left it.

•  Automonitor:

-Provides an overview in a single screen of the performance of your screening program
- Highlights issues which require further investigation
- Complements the existing statistical and monitoring features in αlpha.

•  Statistical analysis

- Calculations up to 30 times faster.
- Selection of date ranges for tabulation directly from graphs of median MoM values

•  Live Screens:

- Screens showing statistical results are updated immediately when the settings are changed.

•  Latest computing technology

- Uses Microsoft® SQL Server®, Windows® Presentation Foundation and .NET framework.
αlpha version 8.0.14273.29 has the option to include additional fields such as sample date and weight in the files imported with the Analyser Import feature.
αlpha version 8.0.15049.39 includes greater flexibility in setting security permissions for individual users.
The number of different ethnic groups has increased from six to eight (overall group plus seven specified groups) in αlpha version 8.0.15049.39.
αlpha version 8.0.15049.39 includes the option of printing the MoM truncation limits used on the report.