Browsing by Subject "early detection"

Now showing 1 - 4 of 4
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    Communicating the Consequences of Early Detection:The Role of Evidence and Framing
    (2001-07) Cox, Dena S.; Cox, Anthony D.
    Despite the enormous benefits of early-detection products, consumers are reluctant to use them. The authors explore this reluctance, testing alternative approaches to communicating the consequences of detection behaviors. The results suggest that anecdotal messages are more involving than statistical messages and that positive anecdotes (about gains from screening) are less persuasive than negative anecdotes (about the losses from failing to get screened); positive anecdotes appear to cause a “boomerang” effect. The authors discuss implications for promoting consumer risk-reduction behaviors.
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    Findings in the Distal Colorectum are not associated with Proximal Advanced Serrated Lesions
    (Elsevier, 2015-02) Kahi, Charles J.; Vemulapalli, Krishna C.; Snover, Dale C.; Jawad, Khaled H. Abdel; Cummings, Oscar W.; Rex, Douglas K.; Department of Medicine, IU School of Medicine
    Background & Aims Serrated lesions are an important contributor to colorectal cancer (CRC), notably in the proximal colon. Findings in the distal colorectum are markers of advanced proximal adenomatous neoplasia. However, it is not known whether they affect the odds of advanced proximal serrated lesions. Methods We performed a retrospective cross-sectional study of data from 1910 patients (59.3 ± 8.0 years, 53.8% female) who underwent an average-risk screening colonoscopy from August 2005 through April 2012 at Indiana University Hospital and an associated ambulatory surgery center. Colonoscopies were performed by an endoscopist with high rates of detection of adenomas and serrated polyps. Tissue samples of all serrated polyps (hyperplastic, sessile serrated adenoma/polyp [SSA/P], or traditional serrated adenoma) proximal to the sigmoid colon and serrated polyps >5 mm in the rectum or sigmoid colon were reviewed by a gastrointestinal pathologist and reclassified on the basis of World Health Organization criteria. Advanced serrated lesion (ASL) was defined as SSA/P with cytologic dysplasia, SSA/P ≥10 mm, or traditional serrated adenoma. Advanced conventional adenomatous neoplasia (ACN) was defined as tubular adenoma ≥10 mm, villous histology, high-grade dysplasia, or cancer. The prevalence of proximal ASL and ACN was calculated on the basis of distal colorectal findings. Multivariable logistic regression analysis was performed to determine the age-adjusted and sex-adjusted odds of advanced proximal adenomatous and serrated lesions. Secondary analyses were performed to examine the effect of variable ASL definitions. Results Fifty-two patients (2.7%) had proximal ASL, and 99 (5.2%) had proximal ACN. Of the 52 patients with proximal ASL, 27 (52%) had no distal polyps. Of the 99 patients with proximal ACN, 40 (40%) had no distal polyps. Age and type of distal adenomas were significantly associated with proximal ACN. There were no significant associations between distal polyp type and proximal ASL. In secondary analyses, distal SSA/Ps (P = .008) but not distal hyperplastic polyps or conventional adenomas were associated with any proximal SSA/P. Conclusions The findings at flexible sigmoidoscopy that traditionally serve as indications for colonoscopy (conventional adenomas) are likely to be ineffective for detection of proximal ASL. This finding, plus the observation that most patients with proximal ASL have no distal polyps, favors screening colonoscopy over sigmoidoscopy, especially in the elderly. The observation that non-advanced distal SSA/Ps are associated with any proximal SSA/P warrants further study.
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    Retinal thickness estimation from SD-OCT macular scans
    (IEEE, 2015-04) Hammes, Nathan; Racette, Lyne; Samuels, B. C.; Tsechpenakis, Gavriil; Department of Computer & Information Science, School of Science
    Glaucoma, a leading cause of blindness worldwide, can be detected using retinal thicknesses from spectral-domain optical coherence tomography (SD-OCT) scans of the macula. We calculate the desired thickness maps as the distance between the inner-limiting membrane (ILM) and retinal pigmented epithelium (RPE) of the retina. To delineate these two layers, we use a set of two deformable open surfaces that are driven by intensity contrast, while preserving their shape and topology properties, i.e. local surface smoothness and inter-surface distance smoothness. To evaluate our method, qualified graders manually segmented 30 random sections from 20 OCT image stacks, in triplicate; we make comparisons with obtained ground-truth and the clinically tested Heidelberg Spectralis segmentation. We show the superiority of our method with respect to accuracy and average execution time (~7 secs), validating it as a clinical tool.
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    Video-based Assessments of Colonoscopy Inspection Quality Correlate with Quality Metrics and Highlight Areas for Improvement
    (Elsevier, 2018) Duloy, Anna; Yadlapati, Rena H.; Benson, Mark; Gawron, Andrew J.; Kahi, Charles J.; Kaltenbach, Tonya R.; McClure, Jessica; Gregory, Dyanna L.; Keswani, Rajesh N.; Medicine, School of Medicine
    Background & Aims Adenoma detection rate (ADR) and serrated polyp detection rate (SDR) vary significantly among colonoscopists. Colonoscopy inspection quality (CIQ) is the quality with which a colonoscopist inspects for polyps and may explain some of this variation. We aimed to determine the relationship between CIQ and historical ADRs and SDRs in a cohort of colonoscopists and assess whether there is variation in CIQ components (fold examination, cleaning, and luminal distension) among colonoscopists with similar ADRs and SDRs. Methods We conducted a prospective observational study to assess CIQ among 17 high-volume colonoscopists at an academic medical center. Over 6 weeks, we video-recorded >28 colonoscopies per colonoscopist and randomly selected 7 colonoscopies per colonoscopist for evaluation. Six raters graded CIQ using an established scale, with a maximum whole colon score of 75. Results We evaluated 119 colonoscopies. The median whole-colon CIQ score was 50.1/75. Whole-colon CIQ score (r=0.71; P<.01) and component scores (fold examination r=0.74; cleaning r=0.67; distension r=0.77; all P<.01) correlated with ADR. Proximal colon CIQ score (r=0.67; P<.01) and component scores (fold examination r=0.71; cleaning r=0.62; distension r=0.65; all P<.05) correlated with SDR. CIQ component scores differed significantly between colonoscopists with similar ADRs and SDRs for most of the CIQ skills. Conclusion In a prospective observational study, we found CIQ and CIQ components to correlate with ADR and SDR. Colonoscopists with similar ADRs and SDRs differ in their performance of the 3 CIQ components—specific, actionable feedback might improve colonoscopy technique.