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Biomedical subjects

D Goldie

Publications and source records attributed to D Goldie.

6 recordsLinked to original sources
PubMed2006

Second-trimester Down's syndrome serum screening: double, triple or quadruple marker testing?

BACKGROUND: The recommendations of the UK National Screening Committee (NSC) are based on the findings of the Serum, Urine and Ultrasound Screening Study (SURUSS). Our study sought to establish if the SURUSS findings, in terms of detection rates (DR) and false-positive rates (FPR) for various second-trimester marker combinations, could be replicated in a local setting. METHODS: We investigated the effects of adding inhibin-A and unconjugated oestriol to our existing double test protocol. This retrospective study examined 1000 control pregnancies and 128 affected pregnancies. RESULTS: The inhibin-A method was associated with considerable assay drift and very marked within-batch imprecision (intrabatch percent coefficient of variation [CV] = 17%). At a cut-off of 1 in 250, the quadruple test showed a DR of 72%, the triple test 70% and the double test 63%. There were no significant differences between the FPRs for any of the combinations, which were all between 6.6% and 7.0% for a 1 in 250 cut-off. CONCLUSIONS: In our view, the current inhibin-A assay is unacceptable as a screening marker due to poor assay performance. We have reviewed the NSC benchmark programme outcomes, and would suggest that the 2005 target of a DR of at least 60% with an FPR of less than 5% is achievable using triple testing in the second trimester in conjunction with universal scan dating. Our results suggest that the April 2007 target of a DR of 75% with an FPR of less than 3% is unachievable using current second-trimester maternal serum screening.

Adolescent↗
PubMed2001

New roles and relationships in the NHS--barriers to change.

The incoming Labour Government's vision for reforming the NHS in Scotland was outlined in the White Paper Designed to Care. While bearing similarities to the proposals outlined for the rest of the UK, it also had distinctive differences. Organisational structures, roles, and relationships between the different parts of the NHS were to be fundamentally altered, particularly in primary and community care. This paper reports upon a series of interviews undertaken across several Health Board areas, with key stakeholders involved in the primary and community sectors. These interviews were intended to examine the development and evolution of the new organisational arrangements, and to identify potential barriers to the successful implementation of Designed to Care. Several barriers and sources of institutional resistance to the new roles and relationships were found during this study, and are discussed. Suggestions upon how these may be overcome and implementation improved are then made.

Community Health Services↗
PubMed1975

Stability of thyroxine and triiodothyronine in biological fluids.

The stability of thyroxine and triiodothyronine in serum has been investigated. Apparent levels of total thryroxine, as determined by two different protein-binding assays employing thyroxine-binding globulin as the binding protein, increased significantly in serum and plasma samples stored at room temperature and were signficantly lower in haemolysed samples. Values did not change significantly in samples stored at 4 degrees C, nor in samples stored at room temperature when determined by radioimmunoassay. Total triiodothyronine levels, as determined by radioimmunoassay, fell slightly on storage. Failure to appreciate the effect of storing samples at room temperature on apparent levels of total thyroxine, as determined by some protein-binding assays, could lead to an incorrect assessment of thyroid status.

Drug Stability↗