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At least 1,207 records · Page 67Linked to original sources
PubMed2005

[Is telemammography an option for screening programs?--A phantom study].

PURPOSE: To show that it is possible to proceed a 20-fold JPEG 2000 wavelet compression of radiographs of a CDMAM phantom without data loss and the usefulness of this technique in telemammography for screening. MATERIAL AND METHODS: After digitizing and a 20-fold data compression, four radiographs of a CDMAM phantom were transferred via ISDN to a PACS archive. Using a soft copy work station, the contrast detail detectability of these data sets was compared to the contrast detail detectability of the original radiographs. RESULTS: The contrast detail detectability showed no difference for the original radiographs and the data sets. CONCLUSION: It is possible to digitize radiographs of a contrast detail mammography phantom, to compress the data sets, to transfer them to a soft copy station and to decompress them without negative influence on the contrast detail detectability.

Contrast Sensitivity↗
PubMed2002

The cost-effectiveness of a "quick-screen" program for abdominal aortic aneurysms.

BACKGROUND: The incidence of abdominal aortic aneurysm (AAA) is increasing, and the prognosis of ruptured AAA remains dismal. Early diagnosis and intervention are crucial. We designed this study to determine whether selected population screening with a brief "quick-screen" ultrasound could be cost-effective. METHODS: A series of 25 patients with risk factors for AAA were evaluated in a blinded fashion by a quick-screen ultrasound and a full conventional study. Times and accuracy for the 2 approaches were compared. An analysis of the cost-effectiveness of screening for AAA was then performed using a Markov model. We determined the long-term survival in quality-adjusted life years and lifetime costs for a hypothetical cohort of 70-year-old males undergoing either AAA screening or not. Our measure of outcome was the cost-effectiveness ratio (CER). RESULTS: The average time for a quick screen was one-sixth that of a conventional study (4 vs 24 minutes). The accuracy of the quick screen was 100%. In our base-case analysis, screening for AAA was cost-effective with a CER of $11,215. Society usually is willing to pay for interventions with CER of less than $60,000 (eg, CER for coronary artery bypass grafting, $9500; breast cancer screening, $16,000). In sensitivity analysis, reducing the cost of screening from $259 (approximate Medicare reimbursement) to $40 (the quick screen) improved the CER to $6850. Moreover, screening populations with increased prevalence of AAA (eg, male with family history [18%]) further improved the CER. CONCLUSIONS: Our analysis demonstrates that ultrasound screening for AAA should be offered to all males above the age of 60. Widespread screening for AAA should be adopted and reimbursed by Medicare and other insurers.

Aged↗
PubMed1977

Urinary screening program to detect renal disease in preschool and kindergarten children.

In an attempt to detect major structural problems of the urinary tract in the early stages 12 006 preschool and kindergarten children (aged 2 to 6 years) were screened for urinary tract infection. Two cases of renal scarring--unilateral in one child and bilateral in the other--were found. It was often difficult to obtain a urine sample and many cultures yielded false-positive results. In terms of cost and effort expended in relation to the low yield of major nephrologic problems, there appears to be no justification at present for routine screening for urinary tract infection in this age group.

Bacteriuria↗
PubMed2000

The aneurysm detection and management study screening program: validation cohort and final results. Aneurysm Detection and Management Veterans Affairs Cooperative Study Investigators.

BACKGROUND: We previously reported the prevalence and associations of abdominal aortic aneurysm (AAA) in 73451 veterans aged 50 to 79 years who underwent ultrasound screening. OBJECTIVE: To understand the prevalence of and principal positive and negative risk factors for AAA, and to assess reproducibility of our previous findings. METHODS: In the new cohort of veterans undergoing screening, 52 745 subjects aged 50 to 79 without history of AAA underwent successful ultrasound screening for AAA, after completing a questionnaire on demographics and potential risk factors. RESULTS: We detected AAA of 4.0 cm or larger in 613 participants (1.2%; compared with 1.4% in the earlier cohort). The direction and magnitude of the important associations reported in the first cohort were confirmed. Respective odds ratios for the major associations with AAA for the second and for the combined cohorts were as follows: 1.81 and 1.71 for age (per 7 years), 0.12 and 0. 18 for female sex, 0.59 and 0.53 for black race, 1.94 and 1.94 for family history of AAA, 4.45 and 5.07 for smoking, 0.50 and 0.52 for diabetes, and 1.60 and 1.66 for atherosclerotic diseases. The excess prevalence associated with smoking accounted for 75% of all AAAs of 4.0 cm or larger in the total population of 126 196. Associations for AAA of 3.0 to 3.9 cm were similar but tended to be somewhat weaker. CONCLUSIONS: Our findings confirm our previous cohort findings. Age, smoking, family history of AAA, and atherosclerotic diseases remained the principal positive associations with AAA, and female sex, diabetes, and black race remained the principal negative associations.

Aged↗
PubMed2006

Assessing the performance of overseas tuberculosis screening programs: a study among US-bound immigrants in Vietnam.

BACKGROUND: Tuberculosis cases in foreign-born persons account for more than 50% of all tuberculosis cases in the United States. The Institute of Medicine has recommended enhancing overseas screening as one measure to support tuberculosis elimination efforts. We assessed the ability of overseas tuberculosis screening (chest radiograph followed by 3 acid-fast bacilli sputum smears for persons with abnormal chest radiographs [suggestive of active tuberculosis]) to detect pulmonary tuberculosis disease among US-bound immigrants with abnormal chest radiographs. METHODS: During October 1998 to October 1999, 14 098 US immigrant visa applicants were screened overseas in Vietnam. Adult applicants with abnormal chest radiographs were enrolled to assess screening test characteristics among this group using mycobacterial culture as the gold standard for pulmonary tuberculosis disease diagnosis. Risk factors for pulmonary tuberculosis disease were also evaluated. RESULTS: Among 1179 adult applicants with abnormal chest radiographs, 82 (7.0%) had positive acid-fast bacilli smear results, and 183 (15.5%) had positive Mycobacterium tuberculosis culture results (pulmonary tuberculosis disease). The sensitivity, specificity, and positive and negative predictive values of serial acid-fast bacilli screening among this group were 34.4% (63/183), 98.1% (977/996), 76.8% (63/82), and 89.1% (977/1097), respectively. Risk factors for pulmonary tuberculosis disease included younger age (18-34 years), no history of tuberculosis or treatment, reported symptoms, and cavitation or consolidation on chest radiograph. CONCLUSIONS: The ability of current overseas screening to detect tuberculosis among immigrants with abnormal chest radiographs is low. Improved diagnostic methods, enhanced screening measures, and postmigration follow-up are essential to control tuberculosis among immigrants and support US and global tuberculosis elimination.

Adult↗