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Re: Triscreen question - long From: art fougner, md (evsono@pipeline.com) Fri May 14 20:12:18 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Larry Glazerman: "Re: Triscreen question" Previous message: Garry E. Siegel, M.D.: "GEN: phone line help" In reply to: Garry E. Siegel, M.D.: "Re: Triscreen question - long" Next in thread: Larry Glazerman: "Re: Triscreen question - long" 60% actually seems a bit low sensitivity. literature suggests about 74 - 95%. Vintzileos suggested that for genetic sonogram to be cost-effective, the sensitivity would have to be at least 74%. what this all boils down to is how sure do the parents want to be - they may certainly have good odds but the stakes may be unacceptably high. if you look at the outside of a fancy building, it doesn't really tell you what grade of concrete went into the foundation. for some centers, notably Benacerraf's, genetic sonogram is not recommended for women over 40 because the prevalence of Down's is high enough to negate the reassurance of a normal ultrasound. Art "Of course, that's just my opinion. I could be wrong." - Dennis Miller At Fri, 14 May 1999, Garry E. Siegel, M.D. wrote: > > NOW she >>wants a Level II to R/O Down... :-) >> >This brings up an excellent issue. My understanding is that level 2 >scans can "pick up" Down about 60%. > >In my big hospital, we have two groups of perinatologists; the older >group was started by a fine radiologist who essentially has been doing >level 2 ultrasound only for years, and until the boarded MFMs arrived, >he was the only show around. He is a fine gentleman and excellent >clinician, and has been joined by several MFMs in their group practice. >He offers level 2 screens to patients and then will reassure them based >on his findings that he can exclude Down with tremendous certainty, thus >avoiding an amnio. Well, patients talk and network, and a few people >come in asking for a scan with him. > >Obviously, since the rate of Down is low, he's not going to miss much, >but I am bothered by this scenario, and, when asked, I tell patients >that what he offers is not the standard, and that level 2 scans only >discover Down about 60%, and if suspected, and amnio is warranted (and >certainly he offers amnio at any point). > >Am I on target here? > >Garry > >-- >Garry E. Siegel, M.D., FACOG >Private Practice >Roswell, Ga. > -- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com Next message: Larry Glazerman: "Re: Triscreen question" Previous message: Garry E. Siegel, M.D.: "GEN: phone line help" In reply to: Garry E. Siegel, M.D.: "Re: Triscreen question - long" Next in thread: Larry Glazerman: "Re: Triscreen question - long"

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