|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: nasal Bones in T1From: Philippe Coquel (philippe.coquel@wanadoo.fr)Thu Nov 22 09:56:20 2001
In fact, there are two problems The paper by F Guy et all speaks about the length of the nasal bone after 14 wa and not before as in the paper of Cicero et al. This is a good but only a biometry paper The second problem is more complex First, the paper, in French, ( [Trisomy 21. 209 cases from the French College of Fetal Ultrasonography. Pertinence of ultrasonographic signs]. Contracept Fertil Sex. 1997 Dec;25(12):VII-XIV. French. No abstract available. PMID: 9497609 [PubMed - indexed for MEDLINE] has been published in a scientific journal without abstract available in Medline. The great majority of sonologists and sonographers in the world don't know this paper because it is in French and because key words research is difficult without abstract. Second and more important: The idea and the collect of cases are good but this is only a series of cases without control group. It is not possible to calculate specificity and LR. More ever, the description of nasal bone abnormalities is some confuse in this paper mixing absence of visualisation of the nasal bone synchondrosis and short nasal bones. In the anomalies of the face, same signs are used twofold and then, calculations are wrong. Because of these major mistakes of methodology, the results of the paper cannot be used in conjunction with the others markers of the trisomy 21 during the second trimester. Now, we use in practice ( for almost of us) only nasal bones visualisation or not, without short nasal bone sign in addition of soft markers It is for this reason that I make some comments last year to try to have a study about the problem with a control group and to know the real sensitivity and specificity of this sign. We don't have great data bases in France It's a big problem to do studies with correct statistic basis. I don't know if members of Nicolaides staff have read the comments but the main thing is the realisation of their study between January and October 2001 (five months later after the discussion here) Their great idea is to have used the 11-14 we exam and not like in France the 22wa exam. Then , main signs of trisomy 21 can be seen during the exam of 11-14 wa The second thing is the very nice and correct statistical analysis. It is fundamental before use a diagnostic test in routine The third is the quality of their conclusions and the comments of H Cuckle . Now, we are waiting for confirmation by others studies but I think that this paper is a giant leap Ph Coquel, MD Dr. Coquel, I agree this is both interesting and exciting; but how is this different from your report here: http://www.obgyn.net/us/us.asp?page=/us/present/0009/nasal_bones or how different from the comments you made in this forum in August 2000? See: http://forums.obgyn.net/ultrasound/ULTRASOUND.0008/0053.html and: http://forums.obgyn.net/ultrasound/ULTRASOUND.0008/0051.html http://forums.obgyn.net/ultrasound/ULTRASOUND.0008/0049.html I also notice that the current article did not reference Le Duff, which you did reference here in August, 2000: "Le Duff, 1997 Trisomy 21. 209 cases from the french college of fetal ultrasonography. Pertience of ultrasound Contracept Fertil Sex 1997 25 12 VII,XIV TRISOMIE 21 237 Cas colligés par le Collège Français" The Cicero, et al article has very nice statistical analysis, but it does seem that they would at least give the prior publications on the nasal bone observation a reference. At any rate, thanks for the heads up on this article. Peace, Terry J DuBose, M.S., RDMS, APS University of Arkansas for Medical Sciences
|
|
Return to
|
Mail a New Message to the Forum: ultrasound@obgyn.net Forum Administrator: terry.dubose@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Thu Oct 2 05:18:24 2008 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.