SEARCH · PubMed Health

Results for “Screening”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 613 records · Page 34Linked to original sources

PubMed2003

Realizing the promise of breast cancer screening: clinical follow-up after abnormal screening among Black women.

BACKGROUND: Delayed or incomplete follow-up after abnormal screening results may compromise the effectiveness of breast cancer screening programs, particularly in medically underserved and minority populations. This study examined the role of socioeconomic status, breast cancer risk factors, health care system barriers, and patient cognitive-attitudinal factors in the timing of diagnostic resolution after abnormal breast cancer screening exams among Black women receiving breast cancer screening at three New York city clinics. METHODS: We identified 184 Black women as having an abnormal mammogram or clinical breast exam requiring immediate follow-up and they were interviewed and their medical records examined. Bivariate and multivariate logistic regression analyses were used to assess the association between patient and health care system factors and diagnostic resolution within 3 months of the abnormal finding. RESULTS: Within 3 months, 39% of women were without diagnostic resolution and 28% within 6 months. Neither socioeconomic status nor system barriers were associated with timely diagnostic resolution. Timely resolution was associated with mammogram severity, patients asking questions (OR, 2.73; 95% CI, 1.25-5.96), or receiving next step information (OR, 2.6; 95% CI, 1.08-6.21) at the initial mammogram. Women with prior breast abnormalities were less likely to complete timely diagnostic resolution (OR, 0.42; 95% CI, 0.20-0.85), as were women with higher levels of cancer anxiety (OR, 0.50; 95% CI, 0.27-0.92). CONCLUSIONS: Interventions that address a woman's prior experience with abnormal findings and improve patient/provider communication may improve timely and appropriate follow-up.

Adult↗

PubMed1998

Screening for amblyopia in preverbal children with photoscreening photographs. National Children's Eye Care Foundation Vision Screening Study Group.

OBJECTIVE: This study aimed to determine the ability of healthcare professionals and lay volunteers to grade photoscreening photographs. DESIGN: The study design was a cross-sectional study. PARTICIPANTS AND INTERVENTION: One hundred children 3 years of age or younger received a complete ophthalmologic examination and were photographed using the Medical Technology Innovations (MTI) photoscreener. Twenty-six children had normal examination results, and the remaining 74 children had conditions that are of interest for pediatric screening, including strabismus, refractive error, media opacities, and ptosis. Eighteen volunteers, including pediatric ophthalmologists, pediatricians, ophthalmic technicians, health department nurses, Prevention of Blindness Society personnel, and Lions Club volunteers, graded each of the 100 photoscreening photographs. MAIN OUTCOME MEASURES: Sensitivity and specificity of vision screening and of photograph grading were measured. RESULTS: Results from various graders yielded sensitivities ranging from 37% to 88% and specificities ranging from 40% to 88%. No single grader achieved sensitivity and specificity both greater than 70%. The grading of the manufacturer's representative had a sensitivity of 43% and a specificity of 85%. Sensitivity decreased to 31% for strabismus and 18% for refractive error when the correct type of strabismus or refractive error was required to be considered true-positives. Results were not positively correlated with the ophthalmologic knowledge of the participant. CONCLUSIONS: The wide variability in sensitivities and specificities among graders indicates inconsistent photograph interpretation skills or deficient screening guidelines or both. For off-axis photoscreening as implemented by the MTI system to become a useful vision-screening method, additional photograph interpretation skill transfer may be beneficial, although not necessarily sufficient.

Allied Health Personnel↗

PubMed1999

Two-year survey of Alberta laboratories processing of antenatal group B streptococcal (GBS) screening specimens: implications for GBS screening programs.

We evaluated specimen types received and methods used by laboratories to process screening GBS specimens from pregnant women. Surveys during 1995 and 1997 of all laboratories in the province of Alberta, Canada that culture GBS from screening genital specimens were completed. Between surveys, there was dissemination of information about appropriate culture techniques. Survey completion rates were 100% in both years (38/38 in 1995 and 20/20 in 1997). During 1995 as compared to 1997, laboratories were less likely to a) have a specific written protocol for identification of genital GBS screening specimens (1995: 78.2% versus 1997: 100%, p = 0.08) b) be receiving combined vaginal-anorectal swabs (1995: 18% of all swabs received versus 1997: 60.4%, p < 0.001), and c) be using selective GBS culture media (1995: 45.5% versus 1997: 86.7%, p = 0.01). Regions using screening based approaches for GBS prevention need to ensure that their laboratories are using adequate techniques for GBS detection.

Alberta↗

PubMed1996

Cholesterol levels in children: to screen or not to screen.

Universal screening and targeted screening are the two approaches used in pediatric practice to identify children with elevated cholesterol levels. This study reports total cholesterol levels in 415 2-year-old children and the relationship of these results to risk factors. Based on these data, universal screening for total cholesterol (TC) does not appear to be necessary. Targeted screening for TC may be the more practical method for identifying children with dangerously high TC elevations.

Child, Preschool↗

PubMed1997

Interval cancers and cancers in non-attenders in the Ostergötland Mammographic Screening Programme. Duration between screening and diagnosis, S-phase fraction and distant recurrence.

The study was based on a population mammographic screening programme for women aged 40-74 years. Metastatic potential was analysed in 843 invasive breast cancers with regard to mode of detection and a number of prognostic factors. There was a higher metastatic capacity in clinically detected cases, but multivariate analyses showed that neither the mode of detection (hazard rate ratio of distant recurrence RR = 1.39, 95% CI 0.78-2.46 interval cancers and RR = 1.6, 95% CI 0.76-3.36 non-attenders) nor the duration between screening and diagnosis for true interval cancers (RR = 0.47, 95% CI 0.16-1.35 in tumours detected later than one year after screening) were independent prognostic factors. A correlation was found between metastatic potential and the SPF (RR = 2.94, 95% CI 1.57-5.50 in tumours with a high SPF), the oestrogen receptor status and the tumour stage. In conclusion, interval cancers intrinsically are not different from other breast cancers with equivalent characteristics; the duration between screening and diagnosis in interval cancers was not clearly correlated to the prognosis, but the S-phase fraction was a powerful predictor of prognosis.

Adult↗

PubMed1998

The role of ultrasound in breast cancer screening. A consensus statement by the European Group for Breast Cancer Screening.

The members of the European Group for Breast Cancer Screening have considered the use of ultrasound in breast diagnosis and breast cancer screening. After wide consultation and a detailed literature review, the consensus of the Group on the role of ultrasound is as follows: current evidence indicates that ultrasound of the breast is an important adjunct to mammography and clinical examination in the further assessment of both palpable and impalpable breast abnormalities. However, the use of ultrasound in population screening of asymptomatic women is associated with unacceptably high rates of both false positive and false negative outcomes. At present there is little evidence to support the use of ultrasound in population breast cancer screening at any age.

Breast Neoplasms↗

PubMed2003

Socioeconomic status & returning for a second screen in the Ontario breast screening program.

In a retrospective cohort study involving 57902 women initially screened between January 1, 1995 and December 31 1997 by the Ontario Breast Screening Program (OBSP), we examined the relationship between geographically derived socioeconomic status (SES) and returning for a second screen. We controlled for age, rurality, preferred language, initial mammography results, previous mammography history, and referral by a health professional. Although SES was related to returning, rurality was an effect modifier of this relationship, a finding not previously reported. Compared to women in the highest ('richest') quintile, urban women in the first and second quintile were less likely to return; this relationship was not found in rural women. Low SES women, particularly in urban areas, should be specifically targeted to increase their likelihood of re-attendance for breast cancer screening within an organized program.

Aged↗

PubMed1999

Visual acuity screening versus noncycloplegic autorefraction screening for astigmatism in Native American preschool children.

INTRODUCTION: Visual acuity screening (VAS) is less reliable in preschoolers than in school-aged children as a means of detecting significant refractive error. We wished to compare the effectiveness of VAS with the effectiveness of an objective method, noncycloplegic autorefraction screening (NCARS), in detecting the presence of significant astigmatism warranting spectacle correction. METHODS: We examined 245 Native American Head Start registrants aged 3 to 5 years. We attempted to obtain uncorrected visual acuity using Lea Symbols logMAR Chart (Precision Vision Inc, Villa Park, Ill), noncycloplegic autorefraction using the Nikon Retinomax K-plus (Nikon Corp, Melville, NY), and cycloplegic refraction (CR) on each eye. The VAS failure criterion was either a 2-line acuity difference between eyes or acuity worse than 20/40 in either eye. The NCARS and CR failure criterion was the spectacle correction threshold exceeding the 50th percentile on the basis of a survey of AAPOS members. RESULTS: We completed VAS in 96% of children and NCARS and CR in 100% of children. There was high prevalence (31%) of significant astigmatic refractive error in this sample. Ten subjects who did not permit bilateral visual acuity measurements were scored as having a positive test result. The sensitivity and specificity of VAS were 90% and 44%, respectively. NCARS had sensitivity and specificity of 91% and 86%, respectively. NCARS becomes cost-effective after 1044 children are screened, assuming that the cost of the autorefractor is 300 times the cost of the referral examination. CONCLUSION: VAS offers high sensitivity but suffers from poor specificity. NCARS greatly reduces the number of unnecessary referrals. In this population, NCARS becomes cost-effective after approximately 1000 children are screened.

Arizona↗

PubMed2006

A scale to screen for DSM-IV Axis I disorders in psychiatric out-patients: performance of the Psychiatric Diagnostic Screening Questionnaire.

BACKGROUND: The Psychiatric Diagnostic Screening Questionnaire (PDSQ) is a reliable and valid self-report scale designed to screen for the most common DSM-IV Axis I disorders encountered in out-patient mental health settings. The present report is the second large-scale validation study of the PDSQ in psychiatric out-patients. Because some of the sizes of the diagnostic groups in the initial report were modest, it is important to determine whether the recommended cut-off scores to screen for psychiatric disorders remained the same in a replication study. METHOD: Six hundred and seventy psychiatric out-patients presenting for treatment were evaluated with a semi-structured diagnostic interview after completing the PDSQ. RESULTS: Based on receiver operating curve analysis, the PDSQ performed as well in the replication sample as in the initial validation study. For nine of the 13 PDSQ subscales the recommended cut-off score in the replication study was the same as in the initial study. After combining the data from the two studies (n=1300) the mean sensitivity across the 13 PDSQ subscales was 87% and the mean negative predictive value was 97%. CONCLUSIONS: The PDSQ is a diagnostic aid designed to improve the efficiency of conducting initial diagnostic evaluations. From a clinical perspective it is important that a screening tool have good sensitivity so that most cases are detected, and high negative predictive value so that most non-cases on the measure are indeed non-cases. The results of this second large validation study indicate that most of the PDSQ subscales achieved this goal.

Adult↗

PubMed2001

Impact of health technology assessment on preventive screening in Belgium: case studies of mammography in breast cancer, PSA screening in prostate cancer, and ultrasound in normal pregnancy.

OBJECTIVE: To describe how scientific evidence has influenced healthcare policy making in Belgium in the field of sickness prevention for mammography, PSA testing in prostate cancer screening, and use of ultrasound in pregnancy. METHODS: Review of published and gray literature and interviews with stakeholders and experts. RESULTS: At the end of 1999, a systematic national/regional screening program had not yet been implemented for any of the three screening strategies. A systematic breast cancer screening program is being prepared for implementation only in Flanders. This limited impact can be attributed to the fragmentation in healthcare policy, the different options among the different regions, fragmentation in healthcare practice, the strong impact of healthcare stakeholders (provider groups and sickness funds) on decision making, and limited attention to scientific evidence in health policy and technology assessment. CONCLUSIONS: Health technology assessment has had very little impact on policy and practice in use of mammography, PSA testing, and ultrasound in pregnancy in Belgium.

Adolescent↗

PubMed1997

Post screen-detected breast cancer within the Screening Mammography Program of British Columbia.

The histological characteristics and extent of mammographic density were compared between 170 post screen-detected (PSD) breast cancers and 466 screen-detected (SD) breast cancers in women attending the Screening Mammography Program of British Columbia. In addition, methods of detection and clinical presentation for the PSD cancers were examined. Invasive ductal, comedo, and medullary carcinoma were significantly more common in PSD cancer in women under age 50 years, and invasive ductal carcinoma in women over age 50 years. Mammographic density was more common in PSD cancers for all age groups under 70 years. The majority of PSD cancers were node negative with no evidence of metastases; however, they tended to be of more advanced stage than SD cancer. Most PSD cancers regardless of age were initially found by the woman herself, presenting as a palpable mass, and the likelihood of being detected within 12 months of the last screening mammogram was higher at younger ages.

Age Factors↗

PubMed2002

Integrating mental health screening and abnormal cancer screening follow-up: an intervention to reach low-income women.

The results of implementing mental health screening within cancer screening and diagnostic programs serving low-income ethnic minority women are reported. Multi-phased screening for anxiety and depression was provided as part of structured health education and intensive case management services to improve abnormal mammogram or Pap test follow-up. Seven hundred fifty-three women were enrolled in the Screening Adherence Follow-up Program. Ten percent (n = 74) met criteria for depressive or anxiety disorder. Women with depressive or anxiety disorders were more likely to have cancer, significant psychosocial stress, fair or poor health status, a comorbid medical problem, and limitation in functional status. Forty-seven women with disorders were receiving no depression care.

Adult↗

PubMed1996

Two infant vision screening programmes: prediction and prevention of strabismus and amblyopia from photo- and videorefractive screening.

Two infant vision screening programmes on total populations in the Cambridge Health District have been designed to identify manifest strabismus and strabismogenic and amblyogenic refractive errors at 7-9 months of age. The first, completed, programme used the isotropic photorefractor with cycloplegia together with a standard orthoptic examination. The second, current, programme uses the VRP-1 isotropic videorefractor to identify infants with accommodative lags which are followed up by refraction under cycloplegia. Both programmes show good agreement between infants identified at screening and retinoscopic refractions at follow-up, showing that photo- and videorefraction (with or without cycloplegia) can be effective methods for screening for ametropia in infants and young children. In each programme 5-6% of infants showed abnormal levels of hyperopia (> or = 3.5 D in any meridian), less than 1% showed anisometropia > or = 1.5 D; very few infants (0.25%) showed -3D myopia or greater. Less than 1% showed manifest strabismus. Hyperopic and anisometropic children entered a randomised controlled trial of partial refractive correction. All children identified at screening, alongside appropriate control groups, are extensively followed up to age 4 years. The first programme has found that children who were hyperopic in infancy were 13 times more likely to become strabismic, and 6 times more likely to show measurable acuity deficits by 4 years, compared with controls. Wearing a partial spectacle correction reduced these risk ratios to 4:1 and 2.5:1 respectively. The impaired acuity can be attributed, in part, to meridional amblyopia resulting from persisting astigmatism. Both hyperopic and myopic infants showed refractive changes in the direction of emmetropia between 9 months and 4 years. Wearing a partial spectacle correction did not affect this process of emmetropisation, but does provide the possibility of reducing the incidence of common pre-school vision problems.

Aging↗

PubMed2000

The effect of nonscreening smears on screening smear results: a statistical analysis with its implications for the NHS cervical screening programme.

This is a statistical analysis of individual NHS Cervical Screening Programme laboratories screening smear 'pick-up' rates (defined here as percentage low grade and percentage high grade of total adequate smears for ages 20-64 years derived from general practitioners and community clinics) in relation to their nonscreening smear workload proportion (here defined as percentage nonscreening smears of total laboratory workload from all sources for all ages). This was achieved by the use of three one way ANOVA models in order to receive a complete overview of the results. The models were applied to the following: (1) Laboratories with a total workload of less than 15000 general practitioner (GP) and community clinic smears; (2) laboratories with a total workload of greater than 15000 GP and community smears and; (3) all laboratories (i.e. a combination of 1 and 2). The 'test' groups within each of these models comprised three subgroups based on the percentage of laboratory workload that consisted of smears from a nonscreening source. This figure ranged from 2.8% to 82.6%. The subgroups were divided so as to contain approximately the same number of laboratories in each one (172 laboratories in total, 42 with workload < 15000 and 130 with > 15000). The results show that laboratories high and low grade pick-up rates have a positively correlated but variable relationship with the proportion of their workload that consists of nonscreening smears. The results show significance overall at the 5% level for high grade and the 10% level for low grade (high grade at P = 0.045 and low grade at P = 0.071). Significance for laboratories viewing less than 15000 screening smears at the 1% level (high grade P = 0.006 and low grade P = 0.005). They show no significance, however, for laboratories viewing more than 15000 screening smears (high grade P = 0.457 and low grade P = 0.622). There is an intriguing possibility that a greater exposure to abnormal smears results in a greater tendency to detect them. The current data provides no evidence to support the NHS Executive's use of 15000 as a designated figure when quality monitoring and service provision becomes a specific issue. The closure or amalgamation of laboratories with workloads less than this would appear to have no scientific evidence base.

Adult↗

PubMed2001

Costs and benefits of cervical screening IV: valuation by women of the cervical screening programme.

OBJECTIVES: To assess the value of the cervical smear test to women, taking account of the positive and negative aspects of the cervical screening service. DESIGN: A postal survey. SETTING: Tayside Health Board region of Scotland. PARTICIPANTS: A sample of 2000 women aged 20-59. MAIN OUTCOME MEASURES: Maximum willingness to pay (WTP) for a cervical smear test. RESULTS: Women were prepared to pay 50.20 British pounds per smear on a 3-yearly basis. Willingness to pay was positively related to income, but unrelated to age and whether or not the respondent had previously had a smear. CONCLUSIONS: Previous studies have estimated the cost per screen or cost per life year saved by cervical screening. This study used the economic instrument of WTP to take account of other potential (dis)benefits to women. The value women place on having a smear was more than the cost to the National Health Service (NHS) of providing the service. The output of a WTP study is potentially useful at the policy level. Future work should explore both the value of alternative approaches to cervical screening, and the value of competing health care interventions.

Adolescent↗

PubMed1998

Women's lay knowledge of cervical cancer/cervical screening: accounting for non-attendance at cervical screening clinics.

An assessment of women's knowledge of cervical screening and cervical cancer was considered important as up to 92% of those dying from this form of cancer had never been tested. What were the reasons which determined their non-attendance? Issues to be addressed were reactions to invitation, women's knowledge of screening, and the possible factors which they envisaged as being associated with cervical cancer. Other issues to be considered were practical problems associated with attendance, and preference for the sex and professional status of the health professionals involved; 187 women in a general practitioner practice in Lothian, Scotland were targeted by questionnaire. As with other studies in this field 50% of those contacted were ineligible for a variety of reasons. Seventy-two women completed the questionnaire, providing a mix of qualitative and quantitative data. Although the majority of women felt the invitation to attend screening was clear and easy to understand, there was a lack of knowledge with regard to both the screening itself and the possible causes of cervical cancer. The main 'causes' were seen as higher sexual activity among those aged under 37 and smoking and a virus by those over 37. The majority of women showed preference for a female professional to take the smear. Practical problems of time and venue were not considered insurmountable. The main reasons cited for non-compliance were the fear and dislike of the test itself.

Adult↗

PubMed2003

Screening for dementia by telephone using the memory impairment screen.

OBJECTIVES: : To develop and assess telephone-based screening tests for dementia, especially Alzheimer's disease (AD). DESIGN: : A cross-sectional validation study nested within a longitudinal study of aging and dementia. SETTING: : The Einstein Aging Study of the Albert Einstein College of Medicine, Bronx, New York. PARTICIPANTS: : Three hundred elderly community volunteers living in Bronx County, 27 of whom were diagnosed with dementia based on in-person clinical evaluation. Of the 27 individuals with dementia, 18 had AD. MEASUREMENTS: : A telephone battery was administered that included the Memory Impairment Screen by telephone (MIS-T, a test of semantic memory), the Category Fluency Test (CF-T), and the Telephone Instrument for Cognitive Status (TICS). An in-person evaluation then followed that included a neurological examination, a neuropsychological battery, demographics, and medical history. RESULTS: : The telephone battery was well accepted. The MIS-T required 4 minutes; the CF-T, 3 minutes; and the TICS, 10 minutes. The MIS-T had excellent sensitivity and specificity when compared with the CF-T and the TICS. Using cutscores on all three tests that provide a sensitivity of 78%, specificity was significantly higher for the MIS-T (93%) than for the CF-T (78%, P<.05) or the TICS (80%, P<.05). Combining the MIS-T and CF-T improved discriminative validity but increased screening time and the complexity of scoring. Normative data for the MIS-T, the CF-T, and the TICS for use in settings with different base rates (prevalence) of dementia are presented in this study. CONCLUSION: : The MIS-T outperforms the CF-T and the TICS as a valid and time-efficient telephone screen for dementia. For applications that require optimal efficiency and accuracy, the MIS-T is recommended.

Aged↗

PubMed1999

Predictive value of past and current screening tests for syphilis in blood donors: changing from a rapid plasma reagin test to an automated specific treponemal test for screening.

BACKGROUND: This study evaluated the change from a rapid plasma reagin (RPR) test to an automated specific treponemal test (PK-TP) in screening for syphilis in blood donors. STUDY DESIGN AND METHODS: A cross-sectional seroprevalence analysis was performed on 4,878,215 allogeneic blood donations from 19 American Red Cross Blood Services regions from May 1993 through September 1995. Positive predictive values relative to the confirmatory fluorescent treponemal antibody absorption test (FTA-ABS) were calculated. Differences in seroprevalence were compared in RPR and PK-TP tests for 1) unconfirmed and confirmed tests, 2) first-time and repeat donors, and 3) "recent" versus "past" infections. Donation data from three additional Red Cross regions were evaluated for repeat donation patterns of blood donors who had a donation that was positive in a serologic screening test for syphilis. The value of RPR and PK-TP tests as surrogate markers for HIV infection was compared. RESULTS: Reactive rates were lower but the positive predictive values was higher for the PK-TP test than for the RPR test. Initially, donors screened by PK-TP were more likely to be confirmed as positive than were donors screened by RPR, but these rates became comparable. It is estimated that a single HIV window-period donation was removed by serologic testing for syphilis each year of this study period. CONCLUSIONS: The change to the PK-TP test resulted in a lower repeatedly reactive rate, better prediction that a confirmed-positive test for syphilis would occur in testing in the FTA-ABS, fewer donations lost, and comparable deferral rates. Because of the high rate of reactivity to serologic testing for syphilis among donors previously confirmed positive for syphilis, indefinite deferral after a confirmed-positive index donation may be warranted. Serologic testing for syphilis is ineffective as a marker of HIV-infectious window-period donations.

Antibody Specificity↗