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  • 1
    Electronic Resource
    Electronic Resource
    Nuclear magnetic resonance spectroscopy of plasma to distinguish between malignant and benign diseases causing jaundice and cholestasis (1993)
    Springer
    Journal of cancer research and clinical oncology 119 (1993), S. 622-626 
    Details
    ISSN: 1432-1335
    Keywords: Cancer ; Jaundice ; Magnetic resonance spectroscopy ; NMR
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The sera of 51 patients with malignant (n=25) and benign (n=26) hepatopancreatobiliary disorders were analysed by1H magnetic resonance spectroscopy (NMR) in order to distinguish between malignant and benign diseases causing jaundice and/or cholestasis. Macromolecular linewidths were determined both manually and automatically with a computed analysis, and both methylene (CH2) and methyl (CH3) resonances were evaluated. The mean linewidth of the CH3 peak was significantly narrower in the patients with malignant disease than in the patients with benign disease both in the manual and computed analyses, but no significant differences in the CH2 peak were detected. Diagnostic sensitivity and specificity of the CH3 peak determined in the computed analysis were 92% and 27% respectively. In the light of the current study, it seems obvious that because overlap between benign and malignant groups was too great,1H NMR spectroscopy of plasma is not of practical value in distinguishing between benign and malignant causes of jaundice and/or cholestasis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01372726
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  • 2
    Electronic Resource
    Electronic Resource
    Tumour-associated trypsin inhibitor in the diagnosis of pancreatic carcinoma (1994)
    Springer
    Journal of cancer research and clinical oncology 120 (1994), S. 494-497 
    Details
    ISSN: 1432-1335
    Keywords: Diagnosis ; Pancreatic cancer ; Tumour markers ; TATI ; TPA ; TPS ; CEA ; CA 50 ; CA 242
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The serum values of tumour-associated trypsin inhibitor (TATI) were measured in a prospective series of 97 patients with jaundice, 36 patients with unjaundiced cholestasis and 21 patients with suspicion of chronic pancreatitis or a pancreatic tumour, to assess its value in diagnosing pancreatic cancer. There were altogether 15 patients with cancer of the pancreas and 2 patients with cancer of the papilla of Vater. The highest serum TATI values were noticed in patients with choledocholithiasis, and raised values were also seen in patients with malignant disease of the liver or bile ducts. In the patients with pancreatic cancer, chronic pancreatitis or benign liver disease, the serum TATI values showed lower levels. The sensitivity of TATI in diagnosing pancreatic cancer was 41.1% with a specificity of 63.5% and an efficiency of 61.0%. In comparison to carcinoembryonic antigen (CEA), carbohydrate antigens CA 50, CA 242, tissue polypeptide antigen and tissue polypeptide-specific antigen, TATI showed a lower diagnostic value. When TATI was analysed in combination with the other markers (two tests positive), the combination of CEA with TATI reached the highest specificity (95.6%), efficiency (89.6%) and positive likelihood ratio (9.3). The results suggest that the diagnostic value of TATI is inferior to that of the established markers, but because of its different nature, it may be of help when used in combination as a complementary serum tumour marker in the diagnosis of pancreatic cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01191804
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Incremental cost‐effectiveness of double‐reading mammograms (1999)
    Springer
    Breast cancer research and treatment 54 (1999), S. 261-267 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer screening ; cost‐effectiveness ; double reading ; mammography screening
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. Double reading is a widely used criterion standard in breast cancer screening despite a lack of evidence of the cost‐effectiveness of the second reading. This study evaluates the incremental cost‐effectiveness of such a strategy. Design. Cost‐effectiveness analysis: Nationwide population‐based semi‐annual screening program for women aged 50–59 in Finland. Participation rate was 91%. All mammograms (95,423) performed during 1990–1995 in three screening centers of the Finnish Cancer Society were read by two radiologists with gradings recorded. The effectiveness of the double reading was the difference in cancers detected in the double compared to that of the single reading. Incremental costs of the double reading for the health care and non‐health care and the time costs were estimated. The main outcome measure was the incremental cost per additional cancer found as a result of the double‐reading strategy. Results. The total number of cancers detected with the double and single reading were 290 and 261, respectively. A significantly higher ratio of carcinoma in situ was the causative pathology in cancers detected only by the second reader. The cost per cancer detected with a single reading was US$ 18,340. The incremental cost of any additional cancer found was US$ 25,523, that is, a 39% higher cost per additional cancer found by double reading. Conclusions. The additional cost per cancer detected by double reading is not drastically higher than with single reading. However, the additional cost per life year saved may be much higher.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006136107092
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    Paper (German National Licenses)
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