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Re: risk recalculationFrom: DuBose, Terry (DuboseTerryJ@uams.edu)Wed Jan 14 10:22:55 2004
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 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
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