--
Ann Polin, MSRS, RDMS
Program Chair
Diagnostic Ultrasound, R130D
Bellevue Community College
3000 Landerholm Circle SE
Bellevue, WA 98007-6484
USA
Telephone: +1 (425) 564-4181
Fax: +1 (425) 564-4193
Email: apolin@bcc.ctc.edu
-----Original Message-----
From: DuBose, Terry [mailto:DuboseTerryJ@uams.edu]
Sent: Wednesday, January 14, 2004 9:25 AM
To: Multiple recipients of list ULTRASOUND
Subject: Re: risk recalculation
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
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-----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
>
> 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
