Probability Of Early Detection Research Articles

Epidemiology of newly diagnosed hypertensives in a tertiary care hospital in a developing country

ABSTRACTBackground: Cardiovascular diseases are the main cause of death in most countries and the past two decades have shown a global increase. Hypertension (HTN) was found to be the leading risk factor in 2010 as qualified by Disability Adjusted Life Years. Epidemiological studies in this regard in Sri Lanka are scarce. Thus, describing epidemiological patterns of HTN in the Sri Lankan population will help policy makers in planning preventive healthcare programs and aid in preparing strategies to cope with the increasing demand for healthcare facilities. Methods: This is a cross-sectional descriptive study conducted at the Teaching Hospital Peradeniya, Sri Lanka, among newly diagnosed hypertensives according to the JNC 7 report, attending the hypertensive clinic through referral. Data were collected by an interviewer administered structured questionnaire, and epidemiological patterns were analyzed. Results: Among 244 newly diagnosed hypertensives, the mean age was 58.3 years (SD = 12.3) and the majority were females. 66.8% had stage 2 HTN (>160 mmHg) at the time of first presentation to a tertiary care center. There was no statistically significant difference of the stage of HTN based on sex, education level, occupation, marital status, consumption of alcohol, and smoking. Conclusion: Majority of the population had very high blood pressure at first diagnosis, indicating delay in the detection of HTN at an early stage. Therefore, measures to increase the probability of early detection of HTN will be useful in reducing morbidity and mortality associated with HTN.

Probability of early detection of ultra-wideband positioning sensor networks

Ultra-wideband (UWB) sensor networks can be efficiently applied to collect data through sensors deployed for preserving environment and rescuing lives. The high-precision positioning capabilities of UWB technology, based on its operation of ultra-short data bearing pulses, can be a reliable solution for such applications. Most of the UWB positioning techniques are based on time-of-arrival of the first path which can be effectively estimated when the probability of early detection (PoED) is accurately evaluated. In this study, we study the PoED of UWB positioning sensor networks subject to narrowband interference modelled with Nakagami-m distribution. We derive novel closed-form approximate expressions which are simpler and have remarkable accuracy compared to the previously published semi-infinite series expressions. Furthermore, to simplify our approach, we present tight lower and upper closed-form bounds for the PoED. Numerical results and simulations are performed to validate the analytical derivations.

The Contributions of Improved Therapy and Earlier Detection to Cancer Survival Gains, 1988-2000

Prior literature has documented improvements in cancer survival over time. However, ambiguity remains over the relative contributions of improved treatment and earlier detection to survival gains. Using registry data, we developed a novel framework to estimate the relative contributions of advances in treatment and detection. Our approach compares changes in the probability of early detection, which we interpret as the effects of advances in detection, to improvements in stage-conditional survival, which we interpret as the effects of treatment. We applied this methodology using SEER data to estimate probabilities of early detection and stage-conditional survival curves for several cancers, by race, between 1988 and 2000. Survival increased for all of the cancers we examined, with blacks experiencing larger survival gains than whites for all cancers combined. Our baseline analysis found that treatment advances account for the vast majority of survival gains for all the cancers examined: breast cancer (83%), lung cancer (85%), colorectal cancer (76%), pancreatic cancer (100%), and non-Hodgkin’s lymphoma (96%). Compared to whites, treatments appear to explain a lower percentage of survival gains for blacks for all cancers combined; breast cancer, NHL, and pancreatic cancer show a higher percentage of survival gains than lung cancer; and roughly the same percentage for the colorectal cancer. These results are robust to sensitivity analyses examining potential length and lead time bias. Overall, our results suggest that while improved treatment and early detection both contributed to the recent gains in survival, the majority of gains from 1988 to 2000 appear to have been driven by better treatment, manifested by improved stage-conditional survival. These results have important policy implications regarding investment in research and development and the evaluation of efforts to improve cancer screening.

A Retrospective Analysis of Risk Factors of Central Nervous System Metastases in Operable Breast Cancer: Different Survival by Biological Subtype and Ki67 Overexpression.

Abstract Background: New agents have improved systemic disease control, but the control of central nervous system (CNS) metastases is still insufficient. The identification of factors that may predispose to CNS metastases may help lead to earlier detection possibly to improvement in disease management.Methods: Patients (pts) with metastatic who were diagnosed with clinical stage I-III primary breast cancer at National Cancer Center Hospital East from January 2003 to December 2005 were screened. All pts with CNS metastases were identified by CT or MRI. Cox proportional hazards models were fitted to find risk factors of CNS metastases. Factors included age, menopausal status, clinical stage, T stage, histological grade, lymphovascular invasion, hormone and HER2 status, and Ki67 (at least 30% tumor cells positive). Survival was calculated by the Kaplan-Meier method.Results: Median follow-up from operation was 53.5 months. Of 591 breast cancer pts, 76 pts (12.9%) relapsed. Seventeen pts (2.9%) developed CNS metastases; 5 pts developed as the first recurrence site. Multivariable analysis indicated the higher risk for developing CNS metastases were triple negative (TN) tumors (HR 5.532, 95% CI 1.445-21.180, p=0.013) and Ki67 overexpression (HR 3.906, 95% CI 1.179-12.939, p=0.026). There were no statistically significant differences in other factors. CNS metastasesCumulative incidence of CNS metastases (4 yrs)Median duration to CNS metastases (Months)Overall survival (4 yrs)Disease free survival (4 yrs)TN9.7% (9/93 pts)9.4%11.378.5%73.3%HER2 positive3.7% (4/107 pts)4.4%20.391.0%84.9%Others1.0% (4/391 pts)0.8% (p<0.0001)24.197.5% (p<0.0001)92.4% (p<0.0001) Ki67 ≥30%8.6% (12/140 pts)9.4%12.382.4%75.0%Ki67 <30%1.1% (5/446 pts)0.7% (p<0.0001)23.996.7% (p<0.0001)92.0% (p<0.0001) Discussion: In our analysis, TN or Ki67 overexpression breast cancer showed earlier CNS metastases and shorter overall survival. In case of these tumors, there is higher probability for early detection of limited CNS metastatic involvement. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6053.

Image-quality standardization for diabetic retinopathy screening

Screening for diabetic eye disease in the UK relies on the correct interpretation of a digital retinal image to identify pathological features in the retina. The lesions that mark the early stages of disease are small, and a number of nonharmful features of similar appearance may confound detection. Early recognition of pathology and prompt treatment can preserve sight. It is, therefore, essential that each component of the digital imaging system is of a sufficient standard to maximize the probability of early detection. The imaging pathway between the patient’s eye and a final diagnostic outcome is discussed in this article, with reference to appropriate national standards for equipment and processes.

Tumor phenotype and characteristics of metastatic brain involvement in breast cancer patients: Potential clinical consequences

1026 Background: Central nervous system metastases (CNS) occur in about 20% of patients with breast cancer. Despite the fact that most of these patients die within a few months, substantial subgroup may survive a year or more. Methods: We performed this study on cohort of 187 breast cancer patients who developed CNS metastases to identify relations between the tumor phenotype and the incidence and characteristics of CNS dissemination, response to the local therapy and overall survival since the development of metastases in brain (OScns). Results: The incidence of monitored phenotypes and other data are included in the table. An unambiguous dependence between the tumor's phenotype and the following attributes has been proven: a) interval between the disease diagnosis and the 1st metastatic event (DFS); b) interval between the 1st metastatic event and the metastases in the CNS (TTPcns); c) characteristics of CNS dissemination. The CNS dissemination was the most extensive in patients with HER-2+ tumors in comparison with HER-2 negat. carcinomas. Surprisingly, patients with triple-negative tumors had the minimal metastatic involvement of CNS defined by size and number of lesions. Phenotype did not correlate with local response to therapy and OScns. The OScns has been significantly prolonged by neurosurgery (median 13,8 vs 2,4 months, p<0.0001) and when the effective local treatment was followed by system treatment (6,1 vs 1,9 months, p<0.0001). Conclusions: Our study has confirmed the dependence between primary tumor phenotype and the time of incidence of metastatic brain affection and character of their spread. Our results encourage the inclusion of CNS imaging examination (CT or MRI) into the regular restaging of patients with HER2 positive and triple-negative primary breast cancer, who are at high risk for early development of CNS dissemination. Especially in case of triple-negative tumors, there is higher probability for early detection of limited CNS metastatic involvement. [Table: see text] No significant financial relationships to disclose.

Risk Assessment of Malicious Biocontamination of Food

Throughout the last decades of the 20th century, the biological threat evolved from primarily a government-controlled weapon to a tool of terrorism. One of the consequences of this trend is the near impossibility of foreseeing when and how an act of bioterrorism will occur. The suitability of food products for such an act stems from the multitude of microorganisms that may be used for contamination and the vulnerability of the products during and after processing. Tests that would enable the detection of a large variety of microorganisms quickly, reliably, and economically should also provide satisfactory means to prevent acts of malicious biocontamination of food products. Until such means become available, a priority-based approach to the problem is probably the most practical. Priorities should be determined based on a systematic risk assessment to define the relative likelihood of a certain microorganism being used in an act of malicious food contamination. Criteria to be evaluated are availability, weaponization processes, delivery of an effective dose, probability of early detection, and the microorganism's resistance to the conditions to which it will be exposed. Because the results of such an assessment may vary according to prevailing conditions, the assessment must be based on the existing circumstances. The results of the assessment should then be applied to the various procedures of food processing, which should further reduce the number of potential microbial threats. Existing methods of screening food for contaminating microorganisms and existing food safety and security procedures such as hazard analysis and critical control point programs may have to be modified to become suitable for the detection of acts of bioterrorism.

The training of psycho-educational technicians (para-professionals) to administer a screening battery which delineates dyslexia and hyperkinesis.

A methodology is described regarding the training of paraprofessionals to administer and score a battery of tests which assesses the areas of intelligence, academics, perception, and behavior. The data could be utilized by the professional diagnostician or educational psychologist to obtain a differential diagnosis of dyslexia and hyperkinesis, i.e., SLD. The training program involved 40 hours of concentrated instruction and 10 participants with varying academic backgrounds and experience. The study indicated that a high percentage of the participants became proficient in the administration and scoring of the battery. These could be expected to test under the direction of a professional diagnostician; thereby increasing the professional's effectiveness and efficiency. The study established no correlation between the participant's previous academic degrees or level of intelligence and the level of proficiency during the training program. A positive correlation existed between the participants who had previous experience with the dyslexic and hyperkinetic child and their level of proficiency attained in the testing program. This positive correlation also existed with participants who were dyslexic or hyperkinetic themselves and the level of proficiency they attained. The study indicated that the training of sufficient numbers of qualified, lower cost, technicians to assist professionals in the preliminary stages of a child's assessment was feasible. This training could be conducted at a lower cost and in a reasonable time frame. This would allow the professional more time for diagnosis, counseling, and prescribing appropriate placement. More children could be addressed at less cost, increasing the probability of early detection, diagnosis, and proper academic placement for dyslexic and hyperkinetic children.