Re: risk recalculation

From: a rae (chichigirl_25@yahoo.com)
Sat Jan 31 22:15:22 2004


I believe it should be http://www.fetalanomalies.org

Ann Polin <apolin@bcc.ctc.edu> 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

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