Re: risk recalculation
From: =?utf-8?B?zpTPgS4gzpnPic6szr3Ovc63z4Igzp3Ouc66zr/Ou865zrTOrM66zrfPgg==?= (nickolidakis@geneticsunit.gr)
Thu Jan 15 13:12:14 2004
where in your website is the file you mention below that I can download it?
Y.Nickolidakis
Athens, Greece.
>----- Original Message -----
From: "David Nyberg" <nyberg@u.washington.edu>
To: "Multiple recipients of list ULTRASOUND" <ultrasound@dns.obgyn.net>
Sent: Wednesday, January 14, 2004 5:58 PM
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
>
