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PubMedDate not supplied

The development and implementation of standards of care in a breast cancer screening program.

The development and implementation of process, structure, and outcome standards were an integral part of program development for a mobile mammography screening program that provides service for the economically disadvantaged through the collaborative effort of eight primary healthcare centers, the Dade County Health Department, and the University of Miami/Jackson Memorial Hospital. The standards are used to guide and evaluate the screening program's operation and to provide the framework for additional program components (e.g., developing performance appraisals and quality assurance and risk management programs, establishing policies and procedures, and serving as the foundation for education and research projects). Examples of standards are provided to assist others in developing a systematic and ongoing evaluation plan for mobile mammography screening.

Breast Neoplasms↗

PubMed1989

[Methodological consideration on evaluation of lung cancer screening program: one-step process and two-step process].

A reasonable method to evaluate lung cancer screening program is to measure the reduction in death rate from lung cancer among those randomly allocated to screening program (one-step process). Alternative method is two-step process; step 1 is to measure what proportion of lung cancer patients, can be detected through screening and how early the screening can detected lung cancer patients, and step 2 is to delineate effectiveness of therapy following early detection. Advantages and disadvantages of the two processes were described in view of statistical power and sample size. In addition, a workplace-based screening program using chest X-ray files was mentioned as an example of step 1 of two-step process. The example also included economical consideration of the screening.

Adult↗

PubMed1992

[25 years Austrian screening program for inborn errors of metabolism at the Vienna University].

The results are presented by the Austrian screening program for inborn errors of metabolism, which is one of the oldest and most comprehensive in the world. At present, the program comprises screening for the following diseases: phenylketonuria, galactosemia, homocystinuria, maple syrup urine disease, hypothyroidism, biotinidase deficiency. The results of the program with regard to diagnosed cases are presented: in total, 747 carriers of various inborn errors of metabolism have been detected by means of the Screening Program and were referred for therapy where appropriate.

Austria↗

PubMed1979

[TSH-screening program for congenital hypothyroidism. Experiences with early thyrotropin (TSH) screening].

14,919 newborn infants were screened for congenital hypothyroidism within the last 5 years using a sensitive TSH method. 10 infants with congenital hypothyroidism were discovered thus presenting a frequency of 1:4500. Four of these infants showed abnormally high TSH levels and normal thyroxine levels. The determination of TSH in cord blood--or combined with the screening program for phenylketonuria--in eluate of dried filter paper specimens is the most sensitive test for primary hypothyroidism without false negative results and a low false positive recall rate of 0.16%. After initiation of therapy with thyroxine the TSH level falls unless therapy is delayed for longer. In the latter case TSH levels may remain elevated for several months despite therapy with thyroxine. We would suggest to start therapy with triiodothyronine for up to 14 days prior to initiation of the usual thyroxine therapy.

Congenital Hypothyroidism↗

PubMedDate not supplied

Community screening programs for diabetes?

Considerable uncertainty and disagreement now prevail concerning the utility and priority of community screening programs for diabetes. A large majority of diabetologists believe that substantial benefits attend the early discovery of diabetes. Official statements of the American Diabetes Association support the view that mitigation of hyperglycemia lowers risk of morbidity. Much recent evidence indicates that aggressive early treatment often improves beta-cell function, thereby diminishing the severity of diabetes. Even so, some diabetologists and public health specialists question the practical benefits of community screening programs. Indeed, there is considerable evidence that, as previously performed, results sometimes have not justified costs. This article suggests that, when well designed, community screening is stil justified in some circumstances. To a considerable degree, failures of the past are correctable. The American Diabetes Association should neither approve nor disapprove community screening indisciminately. Affiliate organizations and health departments should be free to examine available evidence and local circumstances and, then, to decide whether to undertake screening programs. More care is needed in planning, executing, and critically evaluating these programs, but there is impressive and mounting evidence supporting the potential utility of the early discovery of diabetes.

Community Health Services↗

PubMed1990

Counseling strategies for blood cholesterol screening programs: recommendations for practice.

Blood cholesterol screening programs offer an important venue for nutrition counseling aimed at lowering blood cholesterol levels. This paper presents a screening, counseling and referral protocol that has been developed by the Pawtucket Heart Health Program (PHHP). A review of general considerations for counseling strategies in the screening context highlights the necessity for brief, focused, behaviorially oriented tactics. The PHHP Summary and Referral protocol includes a review of multiple risk factors for heart disease, a discussion of blood cholesterol levels, recommendations for eating pattern changes based on response to a food frequency questionnaire, and a final summary and referral as needed. The training of lay volunteers and health professionals in delivery of the program is also reviewed.

Adult↗

PubMed1989

[Results of a multiphase oncology population screening program in the community of Becej 1986-1987. I. The Hemoccult Program].

In the framework of a multiphase oncologic population screening-program performed in persons above 40 years of age according to the census in the community of Becej during 1986-1987, Hemoccult screening program, together with the fluorographic action involved 16.895 (83.80%) persons out of 20.160 predicted ones which was far less than the involvement of persons through the distribution and gathering of the screening material by a specialized nurse. In 907 (5.37%) Hemoccult positive persons out of which 121 (13.34%) persons rejected to cooperate or did not respond to the invitation for further investigation 16 malignant neoplasms in the lower part of the colon (anus 1, rectum 11, sigma 4) were detected as well as 53 polyposes of the rectum and the anus. Besides, 4 malignant neoplasms of the skin were found and 29 benign tumours (27 adenomas of the prostate gland, 1 fibrolipoma glutei and 1 cysta renis). Apart from these diseases 569 other previously not treated pathologic states were found, i.e. new pathologic states were detected in 85.37% of Hemoccult-positive persons. Previously known pathologic states were confirmed in 22.52% of Hemoccult-positive persons. Diagnostic was performed by the rigid rectoscope and in Hemoccult-positive persons with the negative rectoscopis finding radiologic and fiberoscopic investigations were carried out in the less scope due to the deficiency of financial resources. The number of detected malignant neoplasms of the colon surpassed the three-fold value of the average Vojvodina incidence of these localizations of malignant neoplasms at this age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1977

Advocacy and compliance factors in a voluntary selective screening program.

To evaluate factors responsible for compliance with a voluntary selective screening program, we surveyed 495 participants and 212 nonparticipants in a screening program for Tay-Sachs disease. Knowledge about the program and motivation are the most important factors in compliance. The primary incentive for participation was to avoid having abnormal children in future generations.

Adult↗

PubMedDate not supplied

New York State screening program for fragile X syndrome: a progress report.

New York State has established a program to screen post-pubertal mentally retarded males for the fragile X [fra(X)] syndrome. The goal of the program is to identify affected males and inform their families of the diagnosis. Females in these families who are at risk for inheriting the mutation will then be able to determine their carrier status and consider that information in making reproductive decisions. Males were evaluated for 10 features of the syndrome by physicians and nurses throughout the state; cytogenetic analysis was carried out on a subset of this population. A total of 1332 males has been screened and chromosome studies have been completed for 489. Forty-three (9%) were positive for fra(X), and an additional 11 other chromosome abnormalities were identified. The 43 patients belonged to 38 families. Of the 24 families who were informed of the diagnosis, 12 consulted genetic counseling centers for follow-up studies and 12 did not.

Adult↗

PubMed1990

The pros and cons of a mass-media colorectal screening program.

Saint John's Hospital Cancer Center attempted an extensive colorectal screening project encompassing some 34,000 square miles with a population of 13,000,000. Even though our response was encouraging, it still fell far short of expected participants. We found the media played an invaluable role; for as the television coverage diminished, so did the number of kits returned for processing. We wonder if, perhaps, we spread ourselves "too thin." Perhaps the screening program should be more regionally based among community hospitals? Should our targeting be re-directed; ie., towards retirement communities and homes? Is the use of colorectal screening kits truly a cost-effective method of healthcare delivery? These questions can only be answered through further participation of community cancer centers nationally. It is our hope that through continued testing, screening programs will become more refined and productive, ensuring the highest standards of medical care provided to our communities.

California↗

PubMed1992

Nonexperimental evaluation of the effectiveness of a screening program for lung cancer.

The effectiveness of screening to control lung cancer was examined in the German Democratic Republic by analyzing data from a cancer registry and incidence and mortality rates for lung cancer relative to different screening policies, and by two case-control studies. Mortality from lung cancer did not appear to be affected by the screening programs studied. The high cost of mass screening, combined with uncertainty about the benefits of early treatment of lung cancer, outweigh the vague advantages of such screening.

Adult↗

PubMed1992

An initial assessment of the Veterans Affairs occurrence screening program.

The Department of Veterans Affairs (VA) established a computerized occurrence screening program in its medical centers in October 1988. Data collected from these hospitals suggest that occurrence screening has been a useful component of the VA's overall quality assurance effort; opportunities for improvement were found in 4.2% of all occurrences. When asked to name the three most effective criteria, there was strong agreement among participating hospitals--50% or more of the facilities ranked readmissions, death, and admission within three days of an unscheduled outpatient visit as the most effective. A majority of facilities (56%) named occurrence screening as one of the more effective elements in identifying quality-of-care issues. These findings must be balanced against important limitations of the occurrence screening process; however, guided by the data it collected, the VA has recently made several changes in its occurrence screening program to address these limitations.

Data Collection↗

PubMed1976

Effect of a mass screening program on the risk of cervical cancer.

In Finland, the organized mass screening program for the early detection of cervical cancer covers, with few exceptions, all women between the ages of 30 and 55 every fifth year. On the basis of material originating from the Finnish Cancer Registry it was estimated that the probability for a woman aged 30-59 to experience frankly invasive cervical cancer was 0.010 before the screening program, and 0.002 after the first screening. The corresponding probability estimate was 0.022 for pre-invasive lesions subjected to operative treatment. On the assumption that the same relationship applies beyond this age group it was estimated that from 28-39% of the pre-invasive cases progress to invasive cervical cancer, and that 21% of the frankly invasive cases are preceded by a pre-invasive stage of shorter duration than the time period between the screenings, or have no preclinical stage.

Adult↗

PubMedDate not supplied

Effects of news events on response to a breast cancer screening program.

An opportunity to examine the effects of significant, widely reported events on participation in a breast cancer screening program was presented when countrywide public attention was called to breast cancer by reports of the breast surgery of the wives of President and Vice President of United States. These events occurred in September and October 1974 while a breast cancer screening program was underway in the health Insurance Plan of Greater New York. The research design of this program permitted measurements to be made of the participation of the plan's members in the screening before, during, and after these famous mastectomies and of the participants' characteristics during different periods of the research program. In late 1974, when there was great mass media emphasis on breast cancer, participation rates in the breast cancer screening program increased significantly. In the study periods immediately following, however, participation rates declined to previous levels. The increase in Participation rates in late 1974 was fairly uniform among all demographic groups, whether classified by age, education, income, race, or religion. In addition to increases in the participation rate associated with the events of late 1974, there was also an increased tendency among women who were screened to respond readily to mailed invitations to appear for screenings. This increase insensitivity to efforts to win their participation was more pronounced among those groups that this study and other studies have shown are more likely to participate in preventive health programs and to respond more readily to request to participate.

Age Factors↗

PubMed1990

Sociomedical factors affecting participation in screening program on cerebro- and cardio- vascular disease.

In 1984 the Public Health Bureau of Nagoya City began a new health check-up program to encourage citizens aged 40 years to have a medical examination. The rate of participation was 46.6% greater than that of the previous program; however, at about 16%, it was still low. From the survey in Moriyama Ward following results were suggested. Housewives and female part-time workers who had not had a health examination during the previous year showed participation rates of 32.7% and 42.4%, respectively. It would seem that the low rate of participation in the health examination program conducted in the metropolitan area by the municipal Public Health Bureau is due to the existence of many medical care facilities, and the fact that 64.6% of men and 52.6% of women had undergone a medical examination in the year preceding the program. Total screening rates became 69.7% in males and 66.0% in females. Participation rates of 32.7% and 42.4% were achieved by unemployed women and by women with part-time employment, respectively, who had no experience of screening in the previous year. Total screening rates were 63.7% for the unemployed women and 82.1% for the part-time women.

Cardiovascular Diseases↗

PubMed1992

Improving future preventive care through educational efforts at a women's community screening program.

Cervical cancer mortality continues to be a significant problem in the United States. Pap Test screening programs have been effective in attracting high risk women, but the impact of these programs on subsequent health care has seldom been explored. This follow up study examined the impact of a cervical cancer screening and education program on preventive health behaviors of New Hampshire women in the 24 months following the screening program. A mailed survey was sent to a random sample of 750 women from program participants to evaluate both their recent preventive health care practices and to identify perceived barriers to obtaining preventive health services. Of these, 71.1 percent responded. Survey responses of the original program participants were linked to each subject's previous answers to the same questions asked 24 months earlier. A comparison group was derived by asking follow up study participants to identify a female acquaintance within five years of her age. Seventy-four percent of the comparison group responded. Survey responses of original program participants were then compared to those of the comparison group. Results indicate that women who participated in the original Project received significantly more preventive health care services in the two years since the Project than in the two years prior to it. Women in the comparison group received more Paps and clinical breast examinations than women in the participant group, perhaps because all participants had received a Pap test two years before. Having a regular health care provider was the most significant characteristic associated with obtaining indicated preventive services. An important contribution of community screening programs may be to encourage women to establish a regular source of care.

Adult↗

PubMedDate not supplied

Stereopsis testing in a preschool vision screening program.

We conducted a preschool vision screening study using stereopsis testing with the Random Dot E and Lang stereotests as a complement to visual acuity measurement. Over 6000 children were screened. Stereopsis testing at a threshold of 600 seconds of arc was cognitively easier for the children than visual acuity measurement. At this threshold there was no effect on reducing the rate of visual acuity overreferrals, but ten children with abnormal binocular vision were detected who were not referred by visual acuity criteria. Though a large number of children passed only one of the two stereotests, there was no significant difference in their degree of difficulty. Stereopsis testing with these two stereotests may be a useful adjunct to preschool vision screening programs though further studies are required.

Child, Preschool↗

PubMed1988

Comprehensive vision screening program: Illinois' approach.

This article discusses a statewide vision screening program that utilizes trained and certified vision screening technicians under the auspices of the Department of Public Health. Public Act 81-174, the Child Vision and Hearing Test Act, mandates periodic vision screening of children using accepted and approved instruments and standards. The program receives consultation from the Children's Vision Services Advisory Committee, consisting of optometrists, ophthalmologists and others in health and education programs. Topics addressed include: training and certification of technicians; screening, referral and follow-up; program summary of statewide screening statistics of 1.2 million children for fiscal year 1985, etc.

Adolescent↗