Re: risk recalculation
From: art fougner, md (evsono@pipeline.com)
Fri Jan 30 05:59:20 2004
I would think, however, that all LR's will need retooling once NT
screening hits prime time since this should filter out the majority of
Down's cases.
Art
At Thu, 29 Jan 2004, David Nyberg wrote:
>
>I intend to correct the omissions soon at both fetalanomalies and fetalcenter.
>In the mean time, you might also refer patients to a new website I've made at http://www.fetalscreening.com It does include the AAURA excel file that allows you to to do risk calculations. However, the site is designed primarily to answer patient questions ragarding fetal screening.
>
>thanks
>
>David
>
> On Thu, 29 Jan 2004, Ann Polin wrote:
>
>> Also, one of the links doesn't appear to be correct - The
>> http://www.fetalanomalies.com/ doesn't appear to go where it should?
>>
>> 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
>> ---------------------------------------------------------------
>>
>> ---------------------------------------------------------------
>> ---------------------------------------------------------------
>> ---------------------------------------------------------------
>>
>> ---------------------------------------------------------------
>> -----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
>>
>--
>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
>
--
art fougner, md
ich bin ein New Yorker
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