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Re: Calculation of Risk for Down From: D. Nyberg (nyberg@u.washington.edu) Fri Feb 23 15:46:49 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Novakov: "Re: Calculation of Risk for Down" Previous message: art fougner, md: "Re: Ultrasound--diagnosis or treatment?" In reply to: Ph Coquel: "Re: Calculation of Risk for Down" Next in thread: art fougner, md: "Re: Calculation of Risk for Down" Reply: art fougner, md: "Re: Calculation of Risk for Down" There is reasonable evidence to indicate that ultrasound and biochemical markers are largely independent. We can review what data is available, but I'm sure you'll also see more on this in the future. Recall that ultrasound and biochemical markers also are independent in the first trimester so this should not be surprising. Although it would be preferable to offer a combined ultrasound-biochemical risk (as Bahado-Singh has does, and as we will present at the AIUM in a few weeks), a simple method is to base the apriori risk on the triple screen result (biochemistry plus age). We will need further studies to see how accurate that approach is, but for now it seems like a reasonable approach to use in practice. David Nyberg On Fri, 23 Feb 2001, Ph Coquel wrote: > > Doc Gyneco said:: > > > To alter her triple-screen risk you must be sure about statistical > > independance between the serum markers and the hyperechoic bowel marker. > > > > In my opinion, there is no study in this issue. > > > > So, you can't modified the triple screen risk. > > > > And the likelihood ratio could be apply to her age related risk. > > Yes, but in UOG 2000;16:402-406, Verdin and all analyse the value of the > second trimester ultrasound examination among the women whose fetuses were > indicated to be at low risk for chromosomal anomalies on the basis of both > first trimester nuchal translucency measurement and second trimester > biochemical screening > > LLR for echogenic bowel is 283 (71 -1133) 95% IC with 2 abnormal karyotype > for five fetuses at low risk > > But the study numbers are relatively small (5500 pregnacies) and 3548 > considered negative after bichemical screening (7 abnormal karyotype in this > group) > ¨ > Ph Coquel,MD > > Annecy, France > -------------------------------------------------------------------- David A. Nyberg, M.D !!!! -------------------------------------------------------------------- !US! -- -------------------------------------------------------------------- -- / \ // \\ /. \ \ / / \ \\ / . \ .\ /. .\ / // \ / ( ..) \ / o \ / --( )-- \ / ( ) \ / / \ \ _/ /_ ............................ Next message: Novakov: "Re: Calculation of Risk for Down" Previous message: art fougner, md: "Re: Ultrasound--diagnosis or treatment?" In reply to: Ph Coquel: "Re: Calculation of Risk for Down" Next in thread: art fougner, md: "Re: Calculation of Risk for Down" Reply: art fougner, md: "Re: Calculation of Risk for Down"

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