A method for evaluating breast cancer screening strategies using screen-preventable loss of life.

The objective of this study is to describe how screen-preventable loss of life (screen-PLL) can be used to analyze the distribution of life savings with mammographic screening. The determination of screen-PLL with mammography is possible using a natural history model of breast cancer that simulates clinical and pathologic events of this disease. This investigation uses a Monte Carlo Markov model with data from the Surveillance, Epidemiology, and End Results Program; American Cancer Society; and National Vital Statistics System.

Sources of Error in Office Blood Pressure Measurement.

Purposes: To evaluate 2 commonly overlooked sources of error in measuring blood pressure (BP) in the office, improper patient positioning and frequency of terminal digit bias (TDB) using manual and automated (BP) devices.

Methods: BPs recorded by 3 nurses using manual and automated devices were analyzed for TDB. In the next part of the study, 294 patients were recruited and tested with each patient's BP measured twice in the table position and compared with BP measured in the chair position.

Getting the hypertension Dx right: Patient positioning matters.

Taking blood pressure with the patient seated on the edge of an exam table led to misclassification of prehypertension or hypertension in 13.2% of patients.

Insights Into Breast Cancer Screening: A Computer Simulation of Two Contemporary Screening Strategies.

Objective: The debate over the value of screening mammography is rekindled with each new published study or guideline. Central to the discussion are the uncertainties about screening benefits and harms and the criteria used to assess them. Today, the magnitude of benefits for a population is less certain, and the evolving concept of harm has come to encompass false-positives (FPs), unnecessary biopsies, overdiagnosis, and overtreatment.

Comparative analysis of cervical spine management in a subset of severe traumatic brain injury cases using computer simulation.

Background: No randomized control trial to date has studied the use of cervical spine management strategies in cases of severe traumatic brain injury (TBI) at risk for cervical spine instability solely due to damaged ligaments. A computer algorithm is used to decide between four cervical spine management strategies. A model assumption is that the emergency room evaluation shows no spinal deficit and a computerized tomogram of the cervical spine excludes the possibility of fracture of cervical vertebrae.

Impact of cervical spine management brain injury on functional survival outcomes in comatose, blunt trauma patients with extremity movement and negative cervical spine CT: application of the Monte Carlo simulation.

Cervical spine (CS) magnetic resonance imaging (MRI) and collar use may prevent quadriplegia, yet create brain injury. We developed a computer model to assess the effect of CS management strategies on outcomes in comatose, blunt trauma patients with extremity movement and a negative CS CT scan. Strategies include early collar removal (ECR), ECR & MRI, late collar removal (LCR), and LCR & MRI.

Simulation of begin and end ages for mammography screening.

This article is designed to assist healthcare professionals in identifying begin and end ages for annual breast cancer mammography screening through the use of cost-effectiveness and computer modeling. With a limit of acceptability of $50,000 per life-year saved, the ages of screening were found to be 35 to 85. The present study identifies the end age for screening more clearly than currently available evidence while meeting the societal limits of $50,000 per life-year saved and equitable spending for the young and old alike.

Simulation of breast cancer screening: quality assessment of two protocols.

Healthcare professionals must make breast cancer screening decisions without the help of clear answers in current medical knowledge. This study used computer simulation to evaluate two screening protocols. The American Cancer Society (ACS) protocol comprising self-breast examination, professional breast examination and annual mammography was evaluated versus annual mammography alone.

The relation of breast cancer staging to screening protocol compliance: a computer simulation study.

A computer model based on relational database techniques was used to analyze the relationship between staging and population compliance to a breast cancer screening protocol. Stage distribution data permitted estimates of compliance to the protocol. This relationship followed the equation y=5.

A computer model for the study of breast cancer.

A computer model was designed as a relational database to assess breast cancer screening in a cohort of women where the growth and development of breast cancer originates with the first malignant cell. The concepts of thresholds for growth, axillary spread, and distant sites are integrated. With tumor diagnosis, staging was performed that includes clinical and sub-clinical states.