Biomedical subjects

C Coffey

Publications and source records attributed to C Coffey.

At least 19 recordsLinked to original sources

PubMed2006

Dimensional characteristics of DSM-IV personality disorders in a large epidemiological sample.

OBJECTIVE: To assess the five-factor model (FFM) characteristics of young adults with Diagnostic Statistical Manual-IV (DSM-IV) personality disorders in a large community study. METHOD: As part of the eighth wave of a cohort study, 1469 young adults (mean age: 24 years) completed the NEO-five factor inventory, 1145 of whom also had an informant-based personality disorder assessment. RESULTS: The prevalence of personality disorder was 18.6% (95% CI: 16.5-20.7). There were consistent positive associations with neuroticism and negative associations with agreeableness across all three clusters of personality disorder. CONCLUSION: In young adults, high neuroticism and low agreeableness are consistent dimensional characteristics of all personality disorder clusters.

Adult↗

PubMed2005

Health-risk behaviours among adolescent survivors of childhood cancer.

BACKGROUND: The purpose of the study was to investigate smoking, alcohol use, illicit drug use and sexual risk taking among adolescent survivors of childhood cancer treated in Australia. PROCEDURE: A comparison study selecting on exposure (cancer vs. healthy) and administering a branched computerised questionnaire assessing health-risk behaviour, predominately by telephone interview. One hundred fifty-three adolescent survivors of childhood cancer were compared with age matched healthy adolescents drawn from one of two Australian population based surveys of adolescent health. Behaviours assessed were tobacco use, alcohol use, binge drinking, cannabis use, pain reliever use, other illicit drug use and unprotected sex. RESULTS: Compared to their healthy peers, younger survivors (13- to 17-years) were at an increased risk of reporting pain reliever use (OR = 2.1) for non-medical purposes, but lower risk of binge drinking (OR = 0.20), cannabis use (OR = 0.25), other illicit drug use (OR = 0.31), tobacco use (OR = 0.38) and alcohol use (OR = 0.44). Older survivors (18- to 24-years) were at an increased risk of reporting alcohol use (OR 1.5), but at lower risk of reporting cannabis use (OR = 0.27), other illicit drug use (OR = 0.44) and tobacco use (OR = 0.47). Survival analysis using the full adolescent survivor cohort (13- to 24-years) showed that the age of onset of tobacco use was later for cancer survivors (hazard ratio HR = 0.65). CONCLUSION: Adolescent cancer survivors show reduced involvement in most health-risk behaviours, with the exception of pain reliever use among younger survivors and alcohol use among the older survivors. Although risks were reduced a substantial proportion of survivors engage in these behaviours.

Adolescent↗

PubMed2005

Prevalence of headache in Australian footballers.

OBJECTIVE: To survey the prevalence and risk factors for headache in a population of elite professional Australian footballers. METHODS: A prospective questionnaire based survey was performed on elite Australian footballers participating in a national competition. The survey was designed to assess the prevalence and risk factors for headache using standardised International Headache Society (HIS) criteria. Headache prevalence was compared with that of an age and sex matched community control population. RESULTS: A total of 160 questionnaires were analysed. Headaches were reported by 80% of subjects, with 49% of respondents reporting headaches during competitive match play and 60% during training. There was no significant difference between the footballers and the community sample in the number of headaches ever; however, they did report more headaches in the three months before the survey--that is, during the competitive playing season. In the footballers, 22% of headaches conformed to the strict IHS definition of migraine headaches. When the relaxed definition of "footballer's migraine" was used, 34% of headaches met these criteria. Footballers were at significantly increased risk of footballer's migraine than community controls. CONCLUSIONS: Headaches are common in Australian footballers, and the prevalence of migraine is increased in relation to community prevalence studies. Furthermore, the strict IHS criteria may not adequately identify the specific subtype of football related headache. This finding has important implications in the management of headache in this setting.

Australia↗

PubMed2003

The outcome of adolescent eating disorders: findings from the Victorian Adolescent Health Cohort Study.

The study aimed to ascertain the outcome of adolescent onset eating disorders in a representative cohort of females. The design was a seven wave cohort study conducted over 6 years. 982 female participants from a total sample of 2032 secondary school students initially aged 14-15 years at 44 schools in the state of Victoria Australia. Branched questionnaires (BET) were used for assessing symptoms of eating disorder. A partial syndrome was defined where a subject met two DSM-IV criteria for either anorexia or bulimia nervosa. The revised Clinical Interview Schedule (CIS-R) was used for assessing depression and anxiety, and self-report frequency of use and retrospective diaries for substance use. The mean point prevalence of eating disorders in females between 15-18 years at the partial syndrome level was 2.4 % (1.8-31). At follow-up at the age of 20 years the point prevalence was 3 % (1.9-4.1). In all 8.8 % reported an eating disorder across the six year study period. Eleven percent of those with eating disorder in the teens had persisting disorder at follow-up. In contrast, close to 50 % had high levels of depression and anxiety, a finding that was particularly marked for those with the partial syndrome of bulimia nervosa during the teens. The bulimia group tended to report a higher level of heavy alcohol use at follow-up. Eating disorders at the partial syndrome level are common in young women but most teenage syndromes are brief and self-limiting. The findings are consistent with the partial syndrome of bulimia nervosa being viewed as a variant of affective disorder with different associated behaviours at particular developmental points.

Adolescent↗

PubMed2003

Life events and early onset depression: cause or consequence?

BACKGROUND: Adverse life events prior to episodes of depression are assumed to play a causal role. Earlier studies have, however, not adequately controlled for the potential confounding effects of previous depression. METHOD: A two-phase study was nested within a six-wave population based cohort study of 1947 adolescents. Interviews at two assessment phases with the CIS-R and CIDI were used to generate ICD-10 diagnoses of depressive disorder. Life events with longer-term contextual threat were reported for the 6 months before first diagnosis and categorized on the basis of participant appraisal as negative and neutral/positive in effects. Previous depressive and anxiety symptoms were measured 6 months earlier. RESULTS: Pre-existing depressive and anxiety symptoms predicted later events, increasing three-fold the risks for both neutral/positive and negative events in females and increased seven-fold the risk of negative events in males. Life events in turn predicted the onset of depressive disorder independently of previous symptoms. Single negative events held an over five-fold elevated risk and multiple events an almost eight-fold higher risk. Personal threat and loss were associated with disorder in females but not males. CONCLUSIONS: The findings are consistent with a causal role for life events in early episodes of depression. The association also reflects a reciprocal relationship in which earlier symptoms predict later events, perhaps as a result of an individual's attempts to change unfavourable social circumstances.

Adaptation, Psychological↗

PubMed2003

Family risk factors for cannabis use: a population-based survey of Australian secondary school students.

The objective of this study was to investigate relationships between adolescent cannabis use and indices of parent - child attachment, family functioning and parent attitudes to drugs and delinquency. A total of 2848 year 9 and 2363 year 11 students participated in the Victorian Adolescent Health and Well-Being Survey (1999). The study was a school-based random sample of 535 metropolitan and rural, government and non-government secondary schools throughout Victoria, Australia. Cannabis use was defined as 'any' and 'weekly' use in the last 30 days. Multivariate logistic regression was used to identify independent associations between cannabis use and parent - child attachment, family functioning and parent attitudes to drugs and delinquency. Cannabis use in year 9 was associated with permissive parent attitudes to drugs and delinquency (any use: adjusted odds ratio (OR) = 8.1; weekly use: adjusted OR = 7.6), and was particularly sensitive to small changes in the quality of the parent - child relationship with risk increasing threefold for those describing their attachment as 'good' compared with 'very good' (any use: adjusted OR = 2.8, weekly use adjusted OR = 2.9). A similar, but more moderate pattern association was evident in year 11. After adjusting for other family and background factors, poor family functioning showed minimal association with level of cannabis use at both year levels. Results suggest that intervention efforts might sensibly target strengthening parent - children relationships and promoting less permissive parent attitudes to drug use.

Adolescent↗

PubMed2003

Adolescent health education programmes: theoretical principles in design and delivery.

The patterns of health need in youth have changed over the last three decades with increasing rates of psychosocial problems compromising adolescent development and affecting the patterns of morbidity and mortality in adult years. This has increased the public health interest in health promotion, early detection and preventive health care for adolescents. Yet, young people report significant barriers to accessing the health care system, and health professionals report a self-perceived lack of competency and prior training in adolescent health, especially in these areas of youth health need. There is an imperative to provide quality professional development for existing health professionals and undergraduates in adolescent health care. This paper will discuss a model of professional knowledge in adolescent health and the evidence-based principles in design and delivery of effective education programmes. It will also review the published evaluations of adolescent education programmes and outcomes that still require evaluation in the future.

Adolescent↗

PubMed2002

Emergency surgeon-performed hepatobiliary ultrasonography.

BACKGROUND: Acute hepatobiliary pathology is a common general surgical emergency referral. Diagnosis requires imaging of the biliary tree by ultrasonography. The accuracy and impact of surgeon-performed ultrasonography (SUS) on the diagnosis of emergent hepatobiliary pathology was examined. METHODS: A prospective study, over a 6-month period, enrolled all patients with symptoms or signs of acute hepatobiliary pathology. Patients provided informed consent and underwent both SUS and standard radiology-performed ultrasonography (RUS). SUS was performed using a 2-5-MHz broadband portable ultrasound probe by two surgeons trained in ultrasonography, and RUS using a 2-5-MHz fixed unit. SUS results were correlated with those of RUS and pathological diagnoses. RESULTS: Fifty-three consecutive patients underwent 106 ultrasonographic investigations. SUS agreed with RUS in 50 (94.3 per cent) of 53 patients. SUS accurately detected cholelithiasis in all but two cases and no patient was inaccurately diagnosed as having cholelithiasis at SUS (95.2 per cent sensitivity and 100 per cent specificity). As an overall complementary diagnostic tool SUS provided the correct diagnosis in 96.2 per cent of patients. Time to scan was significantly shorter following SUS (3.1 versus 12.0 h, P < 0.05). CONCLUSION: SUS provides a rapid and accurate diagnosis of emergency hepatobiliary pathology and may contribute to the emergency management of hepatobiliary disease.

Adolescent↗

PubMed2001

Parental 'affectionless control' in adolescent depressive disorder.

BACKGROUND: Adults with depressive disorder report high rates of sub-optimal maternal care in childhood. Despite the greater salience of relationships with parents earlier in life, associations with parenting style have not yet been systematically studied in adolescent onset disorder. METHODS: A six-wave, 3-year study of adolescent health in 2032 Australian secondary school students provided an opportunity to undertake a two-phase study of early onset depression. Between waves 2 to 6, a self-administered computerised form of the revised Clinical Interview Schedule (CIS-R) was used to generate a first phase diagnosis of ICD-10 depressive episode. Each subject with a CIS-R-defined depressive episode was selected for second phase assessment together with two subjects from the CIS-R non-cases in each school. Second phase assessment included a second diagnostic assessment using the depression and hypomania modules of the Composite International Diagnostic Interview (CIDI) and assessment of paternal and maternal style using the Parental Bonding Instrument. RESULTS: A total of 1947 out of 2032 subjects in the sampling frame (95.8%) participated in the cohort study (phase 1) at least once; 406 (94%) of the 435 selected subjects completed second phase assessment. One hundred and nineteen subjects fulfilled criteria for depressive episode on the CIS-R at one or more waves. Over the 30-month study period, 69 subjects (10 male, 59 female) fulfilled both CIS-R and CIDI definitions of depression at the same wave and were classified as 'definite depressive disorder'. Low maternal and paternal care held independent associations with both definitions of depression, with the effects clearest in those in the lowest quartile of reported care. After adjusting for low parental care, the associations between high parental control and depression were small. CONCLUSIONS: Sub-optimal parenting is associated with depressive disorder in adolescents. Low maternal and paternal care are each associated with a two- to three-fold higher rate of depressive disorder. These findings are consistent with an effect of sub-optimal parenting on the onset rather than course of disorder. Whether sub-optimal parenting is associated with a risk for the onset of depression outside the adolescent years has yet to be clarified.

Adolescent↗

PubMed2001

Adverse outcomes of alcohol use in adolescents.

AIMS: To compare the occurrence of behaviours occurring under the influence of alcohol in 16-17-year-olds and determine associated risk factors for the different behaviours. DESIGN/SETTING: Cross-sectional survey administered by laptop computers in secondary schools across the state of Victoria, Australia. MEASUREMENT/FINDINGS: The participation rate was 79%. Seventy per cent of participants drank alcohol; 17% of drinkers reported alcohol-related violence (accidents or injuries) and 15% reported problems relating to sex under the influence of alcohol (having sex and later regretting it or having had unsafe sex) in the previous 12 months. Males were more likely to report alcohol-related violence (20% compared to 14% females). Almost one in 10 young people reported having sex while under the influence of alcohol and later regretting it and 10% reported having had unsafe sex. There were no significant gender differences in the reporting rates of alcohol-related sexual risk taking (prop. cum. OR 1.1, 95% CI 0.68-1.9). For alcohol-related injuries, strong independent associations were found with dose of alcohol consumed (prop. cum. OR 2.3, 95% CI 1.3-4.0), frequency of alcohol consumption (prop. cum. OR 2.7, 95% CI 0.94-7.5), antisocial behaviour (prop. cum. OR 2.4, 95% CI 1.4-4.1) and peer drinking (prop. cum. OR 3.3, 95% CI 1.4-8.1). For alcohol-related sexual risk-taking, psychiatric morbidity (prop. cum. OR 4.1, 95% CI 1.9-9.0) and high frequency of alcohol consumption (prop. cum. OR 2.0, 95% CI 0.87-4.6) had strong independent associations. CONCLUSIONS: Physical injury and high-risk sexual behaviour under the influence of alcohol are common in teenagers. Alcohol-related physical injury appears closely related to patterns of alcohol consumption whereas alcohol-related sexual risk-taking is most closely associated with symptoms of depression and anxiety.

Adolescent↗

PubMed2001

Anxiety levels in women attending colposcopy clinics for treatment for cervical intraepithelial neoplasia: a randomised trial of written and video information.

OBJECTIVE: To assess the effectiveness of video information in reducing the level of anxiety in women attending Colposcopy clinics. DESIGN: An observational study followed by a randomised trial. SETTING: Colposcopy Clinic, Royal Free Hospital, London. PARTICIPANTS: Between April and December 1999, all new referrals to the clinic with a cervical smear showing moderate or severe dyskaryosis. MAIN OUTCOME MEASURE: The level of anxiety measured by the Spielberger State Anxiety Inventory. CONCLUSION: Women attending colposcopy clinics for either diagnosis or treatment, experience a high level of anxiety. The highest levels occur in women attending a one-stop see and treat clinic. The introduction of visual information in the form of an explanatory video prior to attendance significantly reduced anxiety.

Anxiety↗

PubMed2001

Development and validation of the Adolescent Asthma Quality of Life Questionnaire (AAQOL).

Current asthma-specific quality of life questionnaires have major conceptual and methodological deficiencies for use in adolescents. The aim of this study was to develop and validate the "Adolescent Asthma Quality of Life Questionnaire (AAQOL)", specifically developed for adolescents with asthma. One-hundred and eleven adolescents with frequent-episodic or persistent asthma aged 12-17 yrs were recruited from three tertiary paediatric asthma clinics. The standardized multi-step method consisted of: 1) item selection including semistructured interviews (n=14); 2) item reduction and validation (n=66); and 3) assessment of reproducibility (n=31). Item reduction was performed applying the clinical impact method. The 32 item AAQOL covers six domains: symptoms, medication, physical activities, emotion, social interaction and positive effects. There was high internal consistency for the six domains (alpha=0.70-0.90) and for the total score (alpha=0.93). Test-retest reliability was high for all domain scores (r=0.76-0.85) and the total score (r=0.90), indicating high reproducibility of the AAQOL. There was high correlation with the paediatric Asthma Quality of Life Questionnaire (rho=0.81) which focuses primarily on symptoms and emotional well-being. There was weak to moderate correlation with clinical parameters of asthma severity (rho=0.25-0.65). The 32-item Adolescent Asthma Quality of Life Questionnaire is a valid, developmentally age-appropriate and dimensionally comprehensive asthma-specific quality of life measure for use in adolescents.

Adolescent↗

PubMed2000

Initiation and progression of cannabis use in a population-based Australian adolescent longitudinal study.

AIMS: To examine predictors of cannabis use initiation, continuity and progression to daily use in adolescents. DESIGN: Population-based cohort study over 3 years with 6 waves of data collection. PARTICIPANTS: 2032 students, initially aged 14-15 years, from 44 secondary schools in the state of Victoria, Australia. MEASUREMENTS: Self-report cannabis use was categorized on four levels (none, any, weekly, daily) and summarized as mid-school (waves 2/3) and late-school (waves 4/5/6) use. Background, school environment, mid-school peer use and individual characteristics were assessed. FINDINGS: Peer cannabis use, daily smoking, alcohol use, antisocial behaviour and high rates of school-level cannabis use were associated with mid-school cannabis use and independently predicted late-school uptake. Cannabis use persisted into late-school use in 80% of all mid-school users. Persisting cannabis use from mid- to late-school was more likely in regular users (odds ratio (OR) 3.4), cigarette smokers (OR any smoking: 2.0, daily smoking: 3.3) and those reporting peer use (OR 2.1). Mid-school peer use independently predicted incident late-school daily use in males (OR 6.5) while high-dose alcohol use (OR 6.1) and antisocial behaviour (OR 6.6) predicted incident late-school daily use in females. CONCLUSIONS: Most cannabis use remained occasional during adolescence but escalation to potentially harmful daily use in the late-school period occurred in 12% of early users. Transition was more likely in males, for whom availability and peer use were determinants. In contrast, females with multiple extreme behaviours were more likely to become daily users. Cigarette smoking was an important predictor of both initiation and persisting cannabis use.

Adolescent↗

PubMed2000

Adolescent depressive disorder: a population-based study of ICD-10 symptoms.

OBJECTIVE: Earlier studies have suggested that symptoms of depressive disorder in adolescents may differ from those found in adults. Even so, diagnostic criteria developed in adults have come to be widely applied to younger subjects. This study examines the frequency of ICD-10 symptoms in depressive disorder and their association with severity in a large community sample of adolescents aged 15 to 18 years. METHOD: A six-wave prospective study of adolescent health and emotional wellbeing in 2032 Australian secondary school students provided an opportunity to conduct a two-phase study of adolescent onset depression. A self-administered computerised form of the revised Clinical Interview Schedule (CIS-R) was used as a first phase diagnostic measure. Second phase assessment using the Composite International Diagnostic Interview (CIDI) allowed the delineation of a group fulfilling criteria on both instruments. The ICD-10 symptoms and severity profiles for depression were generated with standard algorithms. RESULTS: 1947 (95.8%) out of 2032 subjects in the designated sample completed phase 1 assessment at least once. Participation rates at phase 2 interviews were 93%. Over the 30-month study period 69 subjects (10 male, 59 female) fulfilled criteria for ICD-10 depressive episodes on both the CIS-R and CIDI. Thirty-one per cent (n = 21) had experienced a severe episode, 46% (n = 32) moderate and 23% (n = 16) mild episodes. Loss of interest and pleasure, decreased energy and fatigue, sleep disturbance, suicidal ideation and diminished concentration most clearly distinguished adolescents with depressive disorder from controls. Self-reproach and guilt, psychomotor agitation and/or retardation and appetite disturbance with weight change showed the clearest increase in frequency with increasing severity of episode. The somatic syndrome was reported by close to one in three of those with a severe depressive episode, but was uncommon in those with mild and moderate episodes. CONCLUSIONS: The ICD-10 diagnostic criteria are applicable to depressive disorder in older adolescents. With the exception of depressed mood, found in one in five non-cases, all other symptoms were common in cases and uncommon in non-cases. Practitioner awareness of symptoms indicating the presence and severity of disorder should enhance early identification and choice of treatment in adolescent depression.

Adolescent↗

PubMed1999

Analysis of binary outcomes in longitudinal studies using weighted estimating equations and discrete-time survival methods: prevalence and incidence of smoking in an adolescent cohort.

Longitudinal studies are increasingly popular in epidemiology. In this tutorial we provide a detailed review of methods used by us in the analysis of a longitudinal (multiwave or panel) study of adolescent health, focusing on smoking behaviour. This example is explored in detail with the principal aim of providing an introduction to the analysis of longitudinal binary data, at a level suited to statisticians familiar with logistic regression and survival analysis but not necessarily experienced in longitudinal analysis or estimating equation methods. We describe recent advances in statistical methodology that can play a practical role in applications and are available with standard software. Our approach emphasizes the importance of stating clear research questions, and for binary outcomes we suggest these are best organized around the key epidemiological concepts of prevalence and incidence. For prevalence questions, we show how unbiased estimating equations and information-sandwich variance estimates may be used to produce a valid and robust analysis, as long as sample size is reasonably large. We also show how the estimating equation approach readily extends to accommodate adjustments for missing data and complex survey design. A detailed discussion of gender-related differences over time in our smoking outcome is used to emphasize the need for great care in separating longitudinal from cross-sectional information. We show how incidence questions may be addressed using a discrete-time version of the proportional hazards regression model. This approach has the advantages of providing estimates of relative risks, being feasible with standard software, and also allowing robust information-sandwich variance estimates.

Adolescent↗

PubMed1999

Onset of adolescent eating disorders: population based cohort study over 3 years.

OBJECTIVE: To study the predictors of new eating disorders in an adolescent cohort. DESIGN: Cohort study over 3 years with six waves. SUBJECTS: Students, initially aged 14-15 years, from 44 secondary schools in the state of Victoria, Australia. OUTCOME MEASURES: Weight (kg), height (cm), dieting (adolescent dieting scale), psychiatric morbidity (revised clinical interview schedule), and eating disorder (branched eating disorders test). Eating disorder (partial syndrome) was defined when a subject met two criteria for either anorexia nervosa or bulimia nervosa according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). RESULTS: At the start of the study, 3.3% (29/888) of female subjects and 0.3% (2/811) of male subjects had partial syndromes of eating disorders. The rate of development of new eating disorder per 1000 person years of observation was 21.8 in female subjects and 6.0 in male subjects. Female subjects who dieted at a severe level were 18 times more likely to develop an eating disorder than those who did not diet, and female subjects who dieted at a moderate level were five times more likely to develop an eating disorder than those who did not diet. Psychiatric morbidity predicted the onset of eating disorder independently of dieting status so that those subjects in the highest morbidity category had an almost sevenfold increased risk of developing an eating disorder. After adjustment for earlier dieting and psychiatric morbidity, body mass index, extent of exercise, and sex were not predictive of new eating disorders. CONCLUSIONS: Dieting is the most important predictor of new eating disorders. Differences in the incidence of eating disorders between sexes were largely accounted for by the high rates of earlier dieting and psychiatric morbidity in the female subjects. In adolescents, controlling weight by exercise rather than diet restriction seems to carry less risk of development of eating disorders.

Adolescent↗

PubMed1999

A computerised screening instrument for adolescent depression: population-based validation and application to a two-phase case-control study.

Computer-administered questionnaires have been little explored as a potentially effective and inexpensive alternative to pencil and paper screening tests. A self-administered computerised form of the revised Clinical Interview Schedule (CIS-R) was compared with the Composite International Diagnostic Interview (CIDI) in a two-phase study of 2032 Australian high school students (mean age 15.7 years) drawn from a stratified random sample of 44 schools in the state of Victoria, Australia. Prevalence, sensitivity and specificity were estimated using weighting to compensate for the two-phase sampling. Point prevalence estimates of depression using the CIS-R were 1.8% for males and 5.6% for females--an overall prevalence of 3.2%. Prevalence estimates for depression in the past 6 months using the CIDI were 5.2% for males and 16.9% for females--an overall estimate of 12.1%. The CIS-R had a positive predictive value (PPV) of 0.49 and negative predictive value (NPV) of 0.91 for CIDI depression in the past 6 months. Specificity was very high (0.97) but sensitivity low (0.18), indicating that a majority of those with a CIDI-defined depressive episode in the past 6 months were not recognised at a single screening using the CIS-R. Even so, the CIS-R has proved at least as good as any pencil and paper questionnaire in identifying cases for nested case-control studies of adolescent depression. Further exploration of strategies such as serial screening to enhance sensitivity is warranted.

Adolescent↗

PubMed1999

Registration of 3D cerebral vessels with 2D digital angiograms: clinical evaluation.

RATIONALE AND OBJECTIVES: The purpose of this study was to evaluate the accuracy and speed of a new, semiautomatic method of three-dimensional (3D)-two-dimensional (2D) vascular registration. This method should help guide endovascular procedures by allowing interpretation of each digital subtraction angiographic (DSA) image in terms of precreated, 3D vessel trees that contain "parent-child" connectivity information. MATERIALS AND METHODS: Connected, 3D vessel trees were created from segmented magnetic resonance (MR) angiograms. Eleven total DSA images were registered with such trees by using both our method and the current standard (manual registration). The accuracy of each method was compared by using repeated-measures analysis of variance with correction for heterogeneity of variance to evaluate separation of curve pairs on the view plane. Subjective clinical comparisons of the two registration methods were evaluated with the sign test. Registration times were evaluated for both methods and also as a function of the error in the initial estimate of MR angiographic position. RESULTS: The new registration method produced results that were numerically superior to those of manual registration (P < .001) and was subjectively judged to be as good as or better by clinical reviewers. Registration time with the new method was faster (P < .001). If the rotational error in the initial estimate of MR angiographic position is less than 10 degrees around each axis, the registration itself took only 1-2 minutes. CONCLUSION: This method is quicker than and produces results as good as or better than those of manual registration. This method should be able to calculate an initial registration matrix during endovascular embolization and adjust that matrix intermittently with registration updates provided by automatic tracking systems.

Angiography, Digital Subtraction↗