Re: risk recalculation
From: Ph Coquel (philippe.coquel@wanadoo.fr)
Fri Jan 30 06:20:53 2004
all LR's remain the same.
The risk changes after NT filter, not LR's
Ph C
>----- Original Message -----
From: "art fougner, md" <evsono@pipeline.com>
To: "Multiple recipients of list ULTRASOUND" <ultrasound@dns.obgyn.net>
Sent: Friday, January 30, 2004 2:02 PM
Subject: Re: risk recalculation
> I would think, however, that all LR's will need retooling once NT
> screening hits prime time since this should filter out the majority of
> Down's cases.
>
> Art
>
> At Thu, 29 Jan 2004, David Nyberg wrote:
> >
> >I intend to correct the omissions soon at both fetalanomalies and
fetalcenter.
> >In the mean time, you might also refer patients to a new website I've
made at http://www.fetalscreening.com It does include the AAURA excel file
that allows you to to do risk calculations. However, the site is designed
primarily to answer patient questions ragarding fetal screening.
> >
> >thanks
> >
> >David
> >
> > On Thu, 29 Jan 2004, Ann Polin wrote:
> >
> >> Also, one of the links doesn't appear to be correct - The
> >> http://www.fetalanomalies.com/ doesn't appear to go where it should?
> >>
> >> Ann Polin, MSRS, RDMS
> >> Program Chair
> >> Diagnostic Ultrasound, R130D
> >> Bellevue Community College
> >> 3000 Landerholm Circle SE
> >> Bellevue, WA 98007-6484
> >> USA
> >> Telephone: +1 (425) 564-4181
> >> Fax: +1 (425) 564-4193
> >> Email: apolin@bcc.ctc.edu
> >>
> >> -----Original Message-----
> >> From: DuBose, Terry [mailto:DuboseTerryJ@uams.edu]
> >> Sent: Wednesday, January 14, 2004 9:25 AM
> >> To: Multiple recipients of list ULTRASOUND
> >> Subject: RE: risk recalculation
> >>
> >> This is a wonderful web site for patients, professionals, and students
of
> >> sonography: http://www.fetalcenter.org
> >> I will point my students to it.
> >>
> >> The only omissions I noticed was the http://www.CAAHEP.org was not
listed in
> >> the links to standards & guidelines. "Commission on Accreditation of
> >> Allied Health Education Programs (CAAHEP)" accredits DMS programs and
their
> >> Standards & Guidelines and lists of their programs are available there.
The
> >> other omission is Ultrasound@OBGYN.net
> >>
> >> Thanks, Terry
> >>
> >> Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM
> >>
> >> Assistant Professor & Director
> >> Diagnostic Medical Sonography Program
> >> University of Arkansas for Medical Sciences, CHRP
> >> 4301 West Markham St. Mail Slot #563
> >> Little Rock, Arkansas, 72205 USA
> >> 501-686-6510
> >> DuBoseTerryJ@UAMS.edu
> >> http://www.io.com/~dubose/
> >> http://www.uams.edu/chrp/dms/default.asp
> >> http://www.obgyn.net/us/panel/panel.htm
> >> ---------------------------------------------------------------
> >>
> >> ---------------------------------------------------------------
> >> ---------------------------------------------------------------
> >> ---------------------------------------------------------------
> >>
> >> ---------------------------------------------------------------
> >> -----Original Message-----
> >> ---------------------------------------------------------------
> >> From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of
> >> ---------------------------------------------------------------
David
> >> Nyberg
> >> Sent: Wednesday, January 14, 2004 9:58 AM
> >> To: Multiple recipients of list ULTRASOUND
> >> Subject: Re: risk recalculation
> >>
> >> There is good evidence that biochemical markers and ultrasound markers
are
> >> independent. Also, most ultrasound markers are indpendent of one
another.
> >> We have previously reported likelihood ratios for ultrasound markers as
> >> isolated findings, assuming that you also perform a systematic "genetic
> >> sonogram" in the same or similar manner, and the finding really is
isolated
> >> (ie don't forget humerus length shortening). We showed that isolated
EIF
> >> carries a Likelihood ratio of 1.8, or estimate as 2. This does not
apply to
> >> asian populations however, because of the high prevalence of EIF among
> >> asian. Although a right sided EIF is considerably more unusual than a
left
> >> sided one- and I'd be sure you are not identifying the moderator band
rather
> >> than an EIF- I would not change the likelihood ratio based on this
alone.
> >> On the other hand, bilateral EIFs definitely seem to carry a higher
risk- we
> >> just don't know how to quantify that risk yet. So in this case, with
the
> >> caveats mentioned, the risk should be no more than about 1:300 (606/2)
and
> >> in fact a little lower than that if you use a LR of 1.8. In other
words,
> >> the patient remains in the "low risk" category despite the finding
based on
> >> the normal first trimester screen. You can still download or see an
excel
> >> file that quantifies this at an educational website,
http://www.fetalcenter. org
> >>
> >> hope this helps
> >>
> >> David
> >>
> >> On Wed, 14 Jan 2004, Patrizia wrote:
> >>
> >> > dear colleagues
> >> >
> >> > having an ultrascreening risk of 1:606 at 12 th week of gestation the
> >> > finding of a golf ball in the right ventricle at 20 th week of
> >> > gestation, how modify the risk for down syndrome?
> >> >
> >> > thank you for support
> >> >
> >> > dr patrizia
> >> >
> >>
> >> David Nyberg, MD
> >> 10401 E McDowell Mtn Ranch Rd
> >> #2-372
> >> Scottsdale, AZ 85255
> >> ph cell 480-797-0993
> >> fax 480-512-8737
> >> work 480-512-3850
> >>
> >--
> >David Nyberg, MD
> >10401 E McDowell Mtn Ranch Rd
> >#2-372
> >Scottsdale, AZ 85255
> >ph cell 480-797-0993
> >fax 480-512-8737
> >work 480-512-3850
> >
>
> --
> art fougner, md
> ich bin ein New Yorker
