PubMed Health⌕ Search

Biomedical subjects

I Leck

Publications and source records attributed to I Leck.

17 recordsLinked to original sources
PubMed1991

The completeness and accuracy of health authority and cancer registry records according to a study of ovarian neoplasms.

The completeness and accuracy of Hospital Activity Analysis (HAA) and Regional Cancer Registry (RCR) records were investigated in a series of 868 histologically reviewed cases in which primary ovarian neoplasms had been diagnosed according to one or more of seven data sources including HAA and RCR. All the women concerned were residents of Manchester and Salford who had presented in 1979-83 aged 15 years or more. The histological review confirmed the diagnosis of ovarian neoplasia in 829 of these women and excluded it in 39. Among the 829 confirmed cases, 333 were malignant or of borderline malignancy and therefore eligible for registration with the RCR, and 496 were benign. Only 611 (74%) of the 829 cases were listed as ovarian neoplasms or cysts in HAA records of hospital admissions from the study area during the study period, and the HAA diagnosis was incorrect in 40% of the 611 listed cases. Among the 333 borderline or malignant cases, only 241 (72%) appeared among the RCR's registrations of ovarian neoplasms for the study period and area. The RCR record of histological diagnosis was inaccurate in over 20% of these 241 registered cases, although most of the inaccuracies did not affect whether the neoplasm was classified as borderline or malignant. Five per cent of the cases listed as ovarian neoplasms in the HAA file and 15% of those listed as registrable ovarian neoplasms by the RCR should not have been so listed. The findings highlight the limitations of these routine health information systems, both as sources of cases for research and as National Health Service management tools.

Adolescent↗
PubMed1991

A multicentre study of coagulation and haemostatic variables during oral contraception: variations with geographical location and ethnicity. Task Force on Oral Contraceptives--WHO Special Programme of Research, Development and Research Training in Human Reproduction.

A comparative study of the effects of combined oral contraceptives (OC) on coagulation and fibrinolytic variables using standardized laboratory technique and methodology has been performed in Dublin (Ireland), Salvador (Brazil), Santiago (Chile) and Singapore. Of 777 entrants to the study, 622 were randomly allocated to receive one of four different OC formulations. The remainder did not opt for OC. The progestogenic component was levonorgestrel (LNG) in three of the OC formulations and norethisterone acetate (NEA) in the fourth. Results for the three LNG user groups were pooled. The changes in haematological variables observed over 12 months in the LNG and NEA users were examined in relation to the changes seen in the women not on OC. Women in Salvador differed markedly from those in the other three centres, in showing no acceleration of the prothrombin time and no increase in either fibrin plate lysis or plasminogen following the use of OC. After adjusting the findings in OC users for those in non-users, significant differences in response between centres were also detected for activated partial thromboplastin time (accelerated only in Dublin and Santiago), factor VII activity (increased mainly in Salvador and Santiago) and fibrinogen (for which the most marked changes were an increase in Dublin and a decrease in Salvador). This variability between centres in the effects of OC on coagulation and fibrinolysis suggests that OC administration in different populations may not carry equal thrombotic risks.

Adult↗
PubMed1989

The north-south divide in England: implications for health care resource allocation.

Published regional data show that the Standardized Mortality Ratio (SMR) for the northern half of England has recently increased from 113 to 115 per cent of the SMR for the south, and that the north is at least as disadvantaged in respect of morbidity and material deprivation and uses much less private medical care than the south. It is concluded that the north's share of National Health Service (NHS) resources should not be reduced, as it would be if recent proposals by the NHS Management Board were implemented; that a mortality index which gives different weights to deaths at different ages should possibly be used instead of the simple SMR to weight regional resource allocations for need; and that these allocations should also be weighted by some measure of the extent to which regional populations look to the NHS rather than to the private sector for hospital and specialist care.

England↗
PubMed1979

Incidence of myeloid leukaemia in Lancashire.

Identification of a "cluster" of cases of acute myeloid leukaemia and chronic myeloproliferative disorders in Lytham St. Annes, Lancashire, prompted an analysis of the incidence of myeloid leukaemias in Lancashire (excluding Ormskirk Health District), as recorded by the Manchester Cancer Registry. Although statistically there was no significant difference in the trend of incidence between the whole former borough of Lytham St. Annes and the other districts studied, the reported incidence of these diseases in the area as a whole had almost doubled, and in two districts nearly trebled, between two consecutive 6 year periods, beginning in 1965. This represents a substantially larger increase than mortality data suggests has occurred nationally in the same period, and is unlikely to be due solely to more accurate diagnosis or reporting.

England↗
PubMed1978

Incidence of cervical cancer by marital status.

The incidence of invasive cervical cancer by age and marital status was examined, using census statistics and 1968--71 cancer registry data from women who lived in the Manchester Regional Hospital Board area. The relative rarity of the disease in the unmarried and its higher incidence in formerly married than in currently married women was confirmed. This higher incidence was shown to be mainly in widows under 50 and divorced women, suggesting that it is related to the association of the disease with number of sexual partners.

Adult↗
PubMed1976

Methods of classifying and ascertaining children's tumours.

Several methods of ascertaining and classifying childhood neoplasms for epidemiological study have been evaluated using material from the University of Manchester Children's Tumour Registry (CTR), which includes data from several sources on children with neoplasms first seen in the period 1954-73 who were under 15 years old and living in the Manchester Regional Hospital Board area at the time. Two systems of classification-the International Classification of Diseases (ICD) and the Morphology Section of the Manual of Tumor Nomenclature and Coding (MOTNAC; Percy, Berg and Thomas, 1968)-were tested. No major problems arose with the Morphology Section of MOTNAC, and we recommend that the revised version of this section, in the proposed "International Classification of Diseases for Oncology", should be used in epidemiological reports on children's tumours whenever possible. The ICD discriminates less well between the commoner types of childhood neoplasms, but must be retained as a supplementary classification to facilitate international comparisons. A comparison of the completeness of ascertainment achieved in recent years by each source of data showed that more than 98% of the serious cases (neoplasms that were malignant and/or lay within the craniovertebral canal) could have been identified using a combination of Hospital Activity Analysis (HAA) and cancer registration records, and more than 95% using HAA and death records. But in an analysis of 2 years' HAA returns and 6 years' cancer registrations of serious cases, nearly one quarter of the former and one fifth of the latter were shown to record diagnoses which differed from those finally assigned at the CTR. It is concluded that, in epedimiological studies based on routine records, the diagnoses given should always be checked centrally, by experts, in the light of all the available clinical and pathological material (including histological preparations).

Adolescent↗