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Biomedical subjects

V Gilbertsen

Publications and source records attributed to V Gilbertsen.

5 recordsLinked to original sources

Sensitivity, specificity, and positive predictivity of the Hemoccult test in screening for colorectal cancers. The University of Minnesota's Colon Cancer Control Study.

Data are presented on the sensitivity, specificity, and positive predictivity of the Hemoccult test based on the experience of the Minnesota Colon Cancer Control Study, a randomized clinical trial to determine whether the use of the Hemoccult test can reduce mortality from colorectal cancer. Rehydrating the slides with a drop of water before processing resulted in an increase in positivity (2.4% to 9.8%), and sensitivity (80.8% to 92.2%) but a decrease in specificity (97.7% to 90.4%) and positive predictivity (5.6% to 2.2%). The effects of age and sex were also evaluated. The test was less specific for men than women (p = 0.03). Specificity was highest for those less than 60 yr of age and decreased with increasing age (p = 0.05). The positive predictivity increased with age from 1.6% for those under 60 yr to 3.6% for those over 70 yr (p = 0.0004).

Age Factors↗

Screening for colorectal cancer in a high-risk population. Results of a mathematical model.

A mathematical model was used to estimate the cost-effectiveness of colorectal cancer screening strategies for people who are at high risk because of a first-degree relative with colorectal cancer. The model uses indirect evidence about such factors as cancer incidence, sensitivity and specificity of different tests, and treatment effectiveness. The analysis indicates that for screening people over 40 yr old an annual fecal occult blood test may reduce colorectal cancer mortality by about one-third, either colonoscopy or barium enema may reduce mortality by approximately 85%, a 3-5-yr frequency for endoscopies or barium enemas preserves 70%-90% of the effectiveness of an annual frequency, and beginning screening at age 50 reduces effectiveness by 5%-10%. Although both barium enemas and colonoscopies appear to be effective in reducing mortality, the lower cost of the barium enema makes it a more cost-effective strategy. All of these estimates depend on the baseline estimates of each of the factors incorporated in the model; the conclusions are most sensitive to assumptions about the natural history of adenomatous polyps, the bleeding of adenomas and presymptomatic cancers, and the sensitivity of the fecal occult blood test. Recommendations about colorectal cancer screening must also consider factors such as discomfort, inconvenience, and the availability of various technologies.

Colonic Neoplasms↗

The respiratory sinus arrhythmia: a measure of cardiac age.

A method developed for quantifying respiratory sinus arrhythmia (RSA) during voluntary cardiorespiratory synchronization relies on computer-assisted rhythmometric cosinor analysis of instantaneous heart rate data. The RSA was present in all subjects tested, even those at advanced ages. The amplitude of the RSA falls approximately 10 percent per decade. An individual with a transplanted heart and one with severe diabetic neuropathy each had resting RSA values that were normal for their ages. The shape and amplitude of the RSA during voluntary cardiorespiratory synchronization may reflect the suppleness of the heart and its response to rhythmically changing intrathoracic pressure and the subsequent ebb-and-flow of venous return. Our technology allows objective quantitative assessment of the biologic age of the heart and also the effect of any drug, disease, or behavior that affects the RSA.

Adult↗