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Giulio Napolitano

Publications and source records attributed to Giulio Napolitano.

3 recordsLinked to original sources

Methods of calculating prostate-specific antigen velocity.

OBJECTIVES: Numerous methods of calculating PSA velocity (PSAV) are used and have the potential to produce differing PSAV results from the same PSA data. We calculated PSAV using three common methods and compared differences between the methods and their predictive value for prostate cancer diagnosis. METHODS: From a population-based database of PSA results, men with initial PSA<10.0 ng/ml and a subsequent diagnosis of prostate cancer or benign histology were identified. Those with > or =3 PSA tests before diagnosis carried out over a minimum of 18 mo were included. PSAV was calculated by using three methods: The differences between the methods and test characteristics of each method were compared. RESULTS: Of the 2204 men included, 716 (32.5%) were diagnosed with prostate cancer and 1488 (67.5%) benign histology. PSAV differed markedly in each method of calculation. The LR and FL methods had similar predictive values, which were higher than the AE method. There was strong agreement for cancer diagnosis between LR and FL (kappa=0.85), with weaker agreement between LR/AE and FL/AE (kappa=0.69 and 0.66, respectively). CONCLUSIONS: Methods used to calculate PSAV using the same PSA data can produce markedly different results. Linear regression should be the method of choice for calculating PSAV. Using first and last PSA values only may be adequate for everyday clinical use, as long as measurements are separated by a sufficiently long time period.

Aged↗

Electronic patient data confidentiality practices among surgical trainees: questionnaire study.

INTRODUCTION: The objective of this work was to evaluate the safeguards implemented by surgical trainees to protect the confidentiality of electronic patient data through a structured questionnaire sent to Northern Ireland surgical trainees. PARTICIPANTS AND METHODS: A group of 32 basic and higher surgical trainees attending a meeting of the Northern Ireland Association of Surgeons-in-Training were invited to complete a questionnaire regarding their computer use, UK Data Protection Act, 1988 registration and electronic data confidentiality practices. RESULTS: Of these 32 trainees, 29 returned completed questionnaires of whom 26 trainees regularly stored sensitive patient data for audit or research purposes on a computer. Only one person was registered under the Data Protection Act, 1988. Of the computers used to store and analyse sensitive data, only 3 of 14 desktops, 8 of 19 laptops and 3 of 14 hand-held computers forced a password logon. Of the 29 trainees, 16 used the same password for all machines, and 25 of 27 passwords were less than 8 characters long. Two respondents declined to reveal details of their secure passwords. Half of all trainees had never adjusted their internet security settings, despite all 14 desktops, 16 of 19 laptops and 5 of 14 hand-helds being routinely connected to the internet. Of the 29 trainees, 28 never encrypted their sensitive data files. Ten trainees had sent unencrypted sensitive patient data over the internet, using a non-secure server. CONCLUSIONS: Electronic data confidentiality practices amongst Northern Ireland surgical trainees are unsafe. Simple practical measures to safeguard confidentiality are recommended.

Computer Security↗