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At least 451 records · Page 25Linked to original sources
PubMed2002

Very high compliance in an expanded MS-MS-based newborn screening program despite written parental consent.

OBJECTIVES: In Bavaria, Germany, an expanded MS-MS-based newborn screening program was implemented in 1999. The coverage of new additional conditions and novelty of technology required introduction of written parental consent. Here we evaluated the influence of the consent procedure on compliance by systematic demographic tracking. METHODS: Comprehensive information was provided for parents, professionals, and the public. Screening notifications were matched with all birth notifications on name and date of birth. Parents of children without screening notification were contacted and counseled. RESULTS: Between August 1, 1999, and July 31, 2000, 123,284 children eligible for screening were born. Of these, 116,652 were matched successfully. Among 6,632 parents contacted, 2,516 (2%) did not respond. Three thousand thirty-four children were screened but the parents initially refused to participate in tracking. Five hundred ninety-four were screened outside the program. Four hundred eighty-eight untested newborns were identified. Three hundred twenty-five screening failures due to logistic problems were tested subsequently. Screening was definitely refused by the parents of 163 children (0.1% of target population). CONCLUSIONS: With appropriate information provided and surveillance by tracking, high compliance with newborn screening can be achieved despite a written consent requirement.

Adult↗
PubMed2006

First-year results of a community peripheral vascular screening program at an academic community hospital.

Disease associated with the vascular system, including peripheral arterial disease, poses a serious health problem with incidence growing annually. Recognizing this, several health care organizations across the United States have developed programs for public education and community awareness, and for screening individuals at risk for vascular disease. Lehigh Valley Hospital developed and implemented a screening program that evaluated more than 160 individuals during a 12-month period. Results suggest that screening should be limited to patients at high risk; however, the intrinsic value of patient education and patient peace of mind is worth proceeding with the screening effort because patients reported a positive experience.

Aged↗
PubMedDate not supplied

[Compliance, conscious participation, and informed consent in tumor screening programs].

Compliance and coverage are supposed to be indicators of effectiveness in screening activities. Yet effectiveness is a necessary but not sufficient condition for a screening programme: adverse effects are intrinsic to screening practice; to persuade to comply to screening programme should imply that the advantages overwhelm the disadvantages; if at community level the balance is in favour of the screening, it is not possible to predict the weight for each individual of any potential harms. To accomplish individual values is fundamental from ethical point of view: we must avoid non responsible participation or uninformed refusal, through a reliable information on screening benefits and harms to the invited population. Therefore the concept of compliance should be abandon: "participation" should be used instead. The consequence of a different approach to participation in screening evaluation should be appreciated: new indicators and standards have to be defined. The following ones are proposed: prevalence of informed target population; prevalence of consent to invitation within the informed population; ratio consent/refusal to invitation; prevalence of participation in the invited group. It is unrealistic to expect an informed participation, to screening programme, from all population but incorporation of patient values and preferences is seen as the next frontier in attempts to devise valid practice guidelines. Research is needed to develop instrument on risk communication and informed consent, taking into account the current organisation of screening programs.

Humans↗
PubMed2006

California's experience implementing a pilot newborn supplemental screening program using tandem mass spectrometry.

OBJECTIVE: In response to a California legislative mandate, a pilot tandem mass spectrometry (MS/MS) screening program was undertaken by the Genetic Disease Branch of the California Department of Health Services between January 2002 and June 2003. This article outlines the Genetic Disease Branch approach to implementing the MS/MS pilot program and the program evaluation strategies used. METHODS: Through the use of multiple data collection methods, we were able to describe hospital participation patterns, screening test uptake, screening test performance, follow-up services utilization, and provider and family satisfaction with the educational materials and follow-up services provided. RESULTS: During the 18-month pilot program, just more than one half of California's 755,698 newborns were offered MS/MS screening; among this group, 90% of parents chose to have their newborns screened. Fifty-one newborns were identified with MS/MS-detectable disorders, among 461 patients referred for follow-up testing (0.13% of the screened population). One disorder was diagnosed successfully for every 6939 newborns screened and for every 9 infants referred (excluding phenylketonuria). The overall California population prevalence of MS/MS-detectable disorders was 1 case per 6500 infants (excluding phenylketonuria). The positive predictive value for medium-chain acyl-CoA dehydrogenase deficiency was 86.7%, whereas the positive predictive value for short-chain acyl-CoA dehydrogenase deficiency was 21.6%. For a sample from Hawaii, 1 isovaleric aciduria case was detected among 6132 newborns. CONCLUSIONS: Evaluation of the California MS/MS screening pilot program demonstrated that this technology was effective in identifying additional metabolic disorders. The positive predictive value of screening was particularly good for medium-chain acyl-CoA dehydrogenase deficiency. Overall, patient referral rates were very acceptable. The utility of the program was also demonstrated by positive reviews from patients and providers.

California↗
PubMed1997

Effects and sustainability of a cervical screening program in remote Aboriginal Australia.

We assessed the effects of an organised cervical screening program, using a population-based cervical cytology register, for Aboriginal women in the Fitzroy Valley, a remote part of the Kimberley region of Western Australia. Comparison of age-specific screening rates in the area during 1987-88, 1990-92 and 1993-94 showed that establishing the program in late 1989 was accompanied by dramatic increases in cervical screening rates, ranging from two- to over fourfold, with the largest increases in women aged 50 years and over. Following the departure of the coordinator in early 1993, screening rates decreased to between 76 per cent and 29 per cent of their 1990-92 levels, with the largest decreases occurring in the 40-49 and 60-69 years age groups. Rates were still above 1987-88 levels for most age groups. Of 545 women screened during 1991-92, 65 per cent had undergone a second Pap smear within the follow-up period of two to four years. Among women recommended for a repeat smear in two years, the probability of having a second smear was negatively associated with age (log-rank statistic = 35.58, 4 df, P < 0.0001). Follow-up of smears recommended for repeat in 12 months or earlier was less adequate in 1993-94 (46 per cent) than in 1991-92 (75 per cent). The program was successful in recruiting a large proportion of eligible women within a relatively short time, but coverage, especially of older women, was not sustained after a decline in the functioning of the recall system owing to staffing and organisational changes.

Adolescent↗
PubMedDate not supplied

[Results of an auditory screening program in preschool children].

Although important advances have been made in screening for neonatal hearing loss in recent years, there are no extensive studies of other age groups (2 and 3 years). In an audiological study of 284 children of this age using brainstem evoked potentials, we found some degree of deafness in 6.3%, 17% sensorineural and 70% moderate. The large percentage of hearing deficits found in this preschool population suggests that screening programs should be carried out.

Child, Preschool↗
PubMed2001

Evolution of a universal infant hearing screening program in an inner city hospital.

This study reports the evolution of a newborn hearing screening program which began in 1988. Data are reported from the period of time that universal newborn hearing screening was initiated, i.e. April 1996 to December 2000 (total screened=7128 babies). From 1996 to the present, the program has developed to the current form. During 2000, 1713 infants in the well-baby nursery and neonatal intensive care unit were screened at a cost of 18.44 dollars per child. Thirty (1.7%) infants failed the screen, of which 26 (86%) returned for follow-up testing. Fifteen infants were documented with hearing loss, 10 with conductive and five with sensorineural losses. The false positive rate was 0.96% and the overall sensorineural impairment rate was 1/343.

Evoked Potentials, Auditory, Brain Stem↗
PubMed1997

A diabetic retinopathy screening program as a strategy for blindness prevention.

The most frequent cause of preventable blindness in adults, in the developed world, is diabetic retinopathy (DR). The early treatable phase of this complication is clinically silent. In order to institute effective laser photocoagulation and prevention of blindness, timely detection is crucial. Consequently there is a need for periodic funduscopic examinations of all diabetics. Due to the high prevalence of DM in Mexico most of the primary care facilities are limited. We present the results of a DR screening program (DRSP) using a mobile unit equipped with a fundus photography camera, parked outside of a clinic. We report the prevalence of the various stages of DR and clinical characteristics observed in this population as well as our experience working in such an environment. The study period was from September 1 to December 22, 1995. All the diabetics that presented for care to the clinic were identified and all other persons were invited to participate. A total of 231 participants were invited (112 men, 119 women). Non-stereo fundus photos of two retinal fields (macula and optic disk centered) were taken with technique and classification according to international standards. Response rate to the invitation was 95.3%. Mean age was 62.4 +/- 13 years and 63.5 +/- 10 years and duration of diabetes was 12.3 +/- 10.1 years and 11.0 +/- 7.5 years for men and women, respectively. DR was detected in 38% of the cases, of these only 5.6% have received treatment. DR was uncovered in 84.5% of the cases and was associated with duration of diabetes (p < 0.001 in men and p = 0.04 in women) and hyperglycemia (in men p < 0.005, only). DR has a high prevalence in this population and can be detected through a screening program which reveals undiagnosed high risk DR in an efficient, and standardized manner.

Aged↗
PubMed2001

Efficient otoacoustic emission protocols employed in a hospital-based neonatal screening program.

Within the context of a hospital-based newborn hearing screening program, we have studied the application of two OAE protocols (TEOAE and DPOAE) on a group of 250 well babies. The main goal of this study was to evaluate the performance of DPOAE protocol in a relatively large population sample. using a preset number of five tested frequencies, in comparison with a default TEOAE screening protocol. The data were collected on the second day of life and during spontaneous sleep. The TEOAE recordings were acquired with linear protocols using click stimuli of 70-75 dB SPL and were used as indicators of normal cochlear function. The cubic distortion product DPOAE responses were evoked by an asymmetrical 75-65 dB SPL protocol, with a frequency ratio of 1.22. Five frequencies (referring to F2) were tested at 1.5, 2.0, 3.0, 4.0 and 5.0 kHz. The data from the DPOAE responses show a similar pass rate (similarity = 0.98) to the linear TEOAE protocol. The data presented suggest that a DPOAE cochlear evaluation, at 5 pre-selected frequencies, has clinical potential.

Deafness↗
PubMed1998

A three-level hearing screening program for school children.

This study reports the results of a hearing screening program that was conducted in a number of schools in Alexandria region in the school year 1997-1998. Schools were classified according to location into urban and suburban schools. Screening was done in three separate levels. In the first level, screening was done by health visitors in classrooms. To pass the screening in this level, the student had to indicate hearing of 30, 30, 25 & 25 dB tones at 1000, 2000, 4000 & 8000 Hz, respectively. A total of 6180 students were screened in this level, and only 10% of them (614 students) failed. The failing students were referred for the second level of screening in Sporting Hospital for School Students. The screening was done by trained health visitors in sound treated rooms, and to pass this level the child had to indicate hearing of 25 dB tones at 250, 500, 1000, 2000, 4000 & 8000 Hz. From 225 students who attended this level, only 75 students passed. The failing students were assumed to have a hearing problem and were referred for audiologic diagnosis by a consultant audiologist in the third level. The number of students attending the third level were 67 students and all of them had a hearing deficit. In 44 of them occluding wax was the cause of failure and upon its removal they proved to have normal hearing. Twenty three students had hearing loss due to secretory otitis media, chronic suppurative otitis media, or sensory neural hearing loss. The estimated prevalence of hearing loss in school children in this study ranged between 1.17 and 2.59%.

Absenteeism↗
PubMed1977

Evaluation of a screening program for heart disease.

An evaluation of the effectiveness of a screening program using the Phono Cardio Scan to detect heart disease in 18,872 Baltimore (Meryland) elementary school children indicated that few cases were discovered and only one child medical treatment instituted as a result of the program. Most of the children referred to a cardiologist had known disease. There was considerable variability in performance both of the machine and of the three center which were involved in the program. The sensitivity of the machine may have been low as reported in some other studies.

Child↗
PubMed2001

Mass screening program for prostatic cancer in Japan.

Because the idea of "mass screening" in Japan is based upon the concept of "groupism", a fundamental feature of Japanese society, it is very different from the idea of "screening" in Western countries, which arises from an "individualistic" concept. The prevalence of prostatic cancer in Japan remains lower than that in Western countries but it has recently shown a great increase. In this situation, a mass screening program for prostatic cancer, using prostate-specific antigen (PSA) for the primary study, is thought to be promising in Japan. To exclude false-positive cases in the "gray zone" of PSA values, transrectal power Doppler sonography is remarkably effective.

Biopsy↗
PubMed1999

Measurement of the validity of a preschool vision screening program.

OBJECTIVES: The validity (sensitivity and specificity) of a preschool vision screening program was measured over a 3-year period to determine how well strabismus and significant refractive errors could be detected. METHODS: Public health nurses were trained to administer tests of visual acuity, stereoacuity, and ocular alignment. Failure on any test, visual acuity of 6/9 or less, stereoacuity of less than 100 seconds of arc, or an apparent misalignment of the eyes resulted in referral to an eye care practitioner. An age-matched control was also referred. Analysis of practitioner reports used predefined study-based criteria for ocular abnormalities. RESULTS: More than 1100 children were screened each year. The annually calculated prevalence of vision problems ranged between 10.5% and 13.8%. The estimated sensitivity varied from 60.4% to 70.9% (specificity, 69.6% to 79.9%). The yield indicated that a very high percentage of children with vision problems were identified for the first time. CONCLUSIONS: The validity of this screening is comparable to that of other school screenings. The limitations are predictable. Consideration should be given to replacing visual acuity tests with a rapid, objective measure of refractive error and ocular alignment.

Age Factors↗
PubMedDate not supplied

The impact of a stroke screening program.

Stroke is a leading cause of serious disability and is the third leading cause of death in the United States. Prevention and early intervention are key to reducing death and disability from stroke. This study investigated the impact of a community-based stroke-screening program on the knowledge of participants regarding signs and symptoms of stroke, related emergency action, and personal risk factors for stroke. Self-reported behavioral changes were also recorded. Initial data were collected at the screening site as part of the program, and follow-up data were collected by telephone interview at 1, 3, and 6-month intervals after the screening. Of the 107 people who participated in the screening, 85 (79%) participated in all three follow-up interviews. Findings indicate that participants in this community-based stroke-screening program showed increases in their knowledge about stroke, including what a stroke is, signs and symptoms, related emergency action, personal risk factors, and ways to reduce risk. Furthermore, the findings demonstrate that the knowledge was retained throughout the study period. Approximately half of the participants also reported having made at least one behavioral change to reduce their stroke risk.

Aged↗
PubMedDate not supplied

Decreased prevalence of Chlamydia trachomatis infection associated with a selective screening program in family planning clinics in Wisconsin.

The effectiveness of selective screening for control of Chlamydia trachomatis is unknown. In 1986, a statewide screening program began in family planning clinics in Wisconsin after the prevalence of infection among women was found to be 10.7% in four nonurban clinics and 13.7% in an urban Milwaukee clinic. In 1990, endocervical specimens were obtained from 1,757 women attending these same clinics; 5.2% of women in the non-urban clinics and 6.9% in the Milwaukee clinic tested positive for C. trachomatis. Prevalence of infection had decreased similarly (by 53% overall) in both high- and low-risk groups in all five clinics. Although reported condom use increased from 16% to 31%, most other demographic and behavioral risk factors for infection did not significantly change; in contrast, the prevalence of clinical signs of infection decreased. The percentage of infections identified by selective screening criteria decreased from 77% to 55%. Selective screening and attendant activities, as well as an increase in condom use, were associated with a decrease in prevalence of C. trachomatis infection in this population.

Adult↗
PubMedDate not supplied

A comparison of the efficiency of diagnosis of early cervical carcinoma by general practitioners and cytology screening programs in the Netherlands.

The efficiency of general practitioners and cytology screening programs in the Netherlands in diagnosing neoplasia by means of cervical cytology was investigated. For all age groups of women living in rural or urban areas, the general practitioners were almost twice as successful in detecting cases of cervical neoplasia. No reason could be found why the general practitioners were relatively more successful. The important role of the general practitioner and his or her ability to encourage the high-risk group of women to have early and regular smears is stressed.

Adult↗
PubMed1991

[Detection of early prostatic cancer in mass screening program].

Since 1975 up to 1988, we have performed a mass screening program (MS) for prostatic diseases using transrectal ultrasonography (TRS) in the primary study. In our study, 42 cases of prostatic cancer (0.6%) was detected among 6,674 examinees. Out of 42 cases of cancer, 24 (57.1%) were diagnosed as early prostatic cancer (Stage A 1, Stage B 23). The detection rate of cancer in MS and the ratio of early stage of cancer among them were higher than those in the outpatient clinic of our department. Diagnostic accuracy of TRS, palpation and tumor markers in MS were studied respectively through our series of MS. TRS was useful for MS especially in low false negative rate. On the other hand, palpation was characteristic in low false positive rate. Prostatic specific antigen (PSA) among tumor markers was effective to detect early prostatic cancer. However, there were some problems about distinguishing early prostatic cancer from BPH, because of the high false positive rate.

Aged↗