Abstract:
STUDY OBJECTIVE:To compare the costs and effects of routine mammography screening by a single mediolateral-oblique view and two views (mediolateral-oblique plus craniocaudal) of each breast. DESIGN:A cost effectiveness analysis of a prospective non-randomised trial comparing one and two view mammography screening was carried out at St Margaret's Hospital, Epping. All women in the study had two view mammography. The mediolateral-oblique view was always the first image read by the radiologist. After reading the films for a clinic session, the same radiologist then went back and read both the mediolateral-oblique and craniocaudal views together. Each set of films was read by two radiologists. The main outcome measures were recall rates, number of cancers detected, screening and assessment costs, and cost effectiveness ratios. SUBJECTS:A total of 26,430 women who attended for breast screening using both one and two view mammography participated. A sample of 132 women attending for assessment provided data on the private costs incurred in attending for assessment. RESULTS:There was a reduction in the recall rate from 9.1% (2404 of 26,430) after one view screening to 6.7% (1760 of 26,430) after two view screening. The results also suggest that for every 10,000 women screened an additional five cancers would be detected earlier with two view screening. The additional health service screening cost associated with two view screening was estimated to be 3.63 pounds: the costs associated with one and two view screening policies were estimated to be 41.49 pounds and 32.99 pounds respectively. Private costs incurred were estimated to be 0.35 pounds per woman screened and 32.75 pounds per woman assessed. Two cost effectiveness ratios were calculated: an incremental health service cost per additional cancer detected of 4129 pounds and an incremental health service plus private cost per additional cancer detected of 2742 pounds. The sensitivity analysis suggested that the results were sensitive to relatively large changes in a number of parameters. These included screening costs, assessment costs, equipment life, and recall rates. CONCLUSIONS:Use of two view screening increased early cancer detection and also costs. The reduction in the recall rate with two views was not sufficiently large to make the cost of two view screening neutral. While these results are not completely generalisable, a framework is provided to allow other centres to estimate the cost effectiveness of two view screening in their locality.
journal_name
J Epidemiol Community Healthjournal_title
Journal of epidemiology and community healthauthors
Bryan S,Brown J,Warren Rdoi
10.1136/jech.49.1.70subject
Has Abstractpub_date
1995-02-01 00:00:00pages
70-8issue
1eissn
0143-005Xissn
1470-2738journal_volume
49pub_type
杂志文章abstract:BACKGROUND:HIV incidence estimates are crucial in understanding and predicting the HIV/AIDS epidemic and identifying sub-populations and regions most at risk for the epidemic. However, incidence estimation is a challenge due to the nature of the disease and type of data available. This paper aims to present a simple an...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2009.091959
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Incarceration is simultaneously a public health opportunity and a public health concern. We examined the association between maternal/partner incarceration in the year prior to birth and perinatal smoking. METHODS:We pooled 2006-2010 data from the Centers for Disease Control and Prevention's Pregnancy Risk ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2014-204820
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Although working smoke alarms halve deaths in residential fires, many households do not keep alarms operational. We tested whether theory-based education increases alarm operability. METHODS:Randomised multiarm trial, with a single arm randomly selected for use each day, in low-income neighbourhoods in Mary...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,随机对照试验
doi:10.1136/jech-2014-204182
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:To assess the effect of the Demerit Point System (DPS), introduced in Spain on 1 July 2006, on the number of fatalities due to road traffic accidents, using a methodology that controls for the seasonal variation and trend in the data series. METHODS:Time-series analysis by ARIMA models of 29 113 fatalities ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2008.082461
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:School systems are increasingly typified by diversity of provision, parental choice and publication of performance data. Schools shape their students' lifestyles and health, but the effects of 'marketisation' are under-researched. The authors use qualitative data to develop a logic model regarding such effec...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2011.137539
更新日期:2012-07-01 00:00:00
abstract:STUDY OBJECTIVE:This paper addresses the environmental justice implications of children's health by exploring racial/ethnic disparities in potential exposure to air pollution, based on both school and home locations of children and three different types of pollution sources, in Orange County, Florida, USA. METHODS:Usi...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2006.054130
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Little is known about how diet-related and activity-related amenities relate to residential location behaviour. Understanding these relationships is essential for addressing residential self-selection bias. METHODS:Using 25 years (6 examinations) of data from the Coronary Artery Risk Development in Young Ad...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2016-207249
更新日期:2017-03-01 00:00:00
abstract:STUDY OBJECTIVES:To estimate ethnic and socioeconomic differences in breast cancer incidence and survival between South Asians and non-South Asians in England and Wales, and to provide a baseline for surveillance of cancer survival in South Asians, the largest ethnic minority. SETTING:115 712 women diagnosed with firs...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2004.030965
更新日期:2005-05-01 00:00:00
abstract::Systematic screening of death certificates referable to residents of two health districts covered by a psychiatric case register allows the study of excess mortality in unselected psychiatric patients from a defined area of known population. Deaths among the case register patients exceeded those expected by 80%; the r...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.42.3.286
更新日期:1988-09-01 00:00:00
abstract::In epidemiological studies the diagnosis of a past history of myocardial infarction is made from the answer to a single question: "Have you ever had a severe pain across the front of your chest lasting for half an hour or more?" Two additional questions, which form an optional part of the London School of Hygiene and ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.42.2.116
更新日期:1988-06-01 00:00:00
abstract:STUDY OBJECTIVE:To analyse the role played by socioeconomic factors and self rated general health in the prediction of the reporting of severe longterm illness, and the extent to which these factors explain social class differences in the reporting of such illness. DESIGN:Analysis of panel data from the survey of livi...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.50.2.156
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Existing research points towards physical and mental health gains from housing improvements, but findings are inconsistent and often not statistically significant. The detailed characteristics and variability of housing improvement works are problematic and studies are often small, not experimental, with sho...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2014-204064
更新日期:2015-01-01 00:00:00
abstract::Much of the recent controversy surrounding the relation between fetal death and pregnancy order has centred around the appropriateness of different types of analyses. In the present paper the interpretation of various methods are discussed with reference to "real" and "hypothetical" data. The pattern of results obtain...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.38.1.29
更新日期:1984-03-01 00:00:00
abstract:BACKGROUND:Evidence on the role of cannabis as a gateway drug is inconsistent. We characterise patterns of cannabis use among UK teenagers aged 13-18 years, and assess their influence on problematic substance use at age 21 years. METHODS:We used longitudinal latent class analysis to derive trajectories of cannabis use...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2016-208503
更新日期:2017-08-01 00:00:00
abstract:STUDY OBJECTIVES:To describe the prevalence of hepatitis B virus (HBV) infection in patients with sexually transmitted diseases (STD) and human immunodeficiency virus (HIV) infection, and to determine the role of sexual transmission of HBV infection in Singapore. DESIGN:A cross sectional study of all consecutive men p...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.49.3.309
更新日期:1995-06-01 00:00:00
abstract::A questionnaire relating to smoking habits, respirator symptoms, and health attitudes was administered to 10 498 secondary schoolchildren in 1975. The results reported in this paper indicate that children who smoke regularly have a higher prevalence of upper respiratory tract infections and a higher incidence of the r...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.32.1.53
更新日期:1978-03-01 00:00:00
abstract:INTRODUCTION:While many epidemiological studies have shown that low outdoor temperatures are associated with increased rates of hospitalisation and mortality (especially for respiratory or cardiovascular disease), very few studies have looked at the association between indoor temperatures and health. Such studies are c...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,随机对照试验
doi:10.1136/jech-2013-202632
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Several studies have found that an increased level of ambient particulate matter (PM) smaller than 2.5 microns (PM2.5) is associated with an increased risk of OHCA. We investigated the relationship between air pollution levels and the...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2013-202955
更新日期:2014-01-01 00:00:00
abstract:STUDY OBJECTIVE:The aim of this paper is to systematically review and analyse the validity and reliability of Antonovsky's life orientation questionnaire/sense of coherence scale (SOC). DESIGN:The study is descriptive and analytical with a systematic integration of the contemporary knowledge base on the salutogenic re...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech.2003.018085
更新日期:2005-06-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate and evaluate published data on cost effectiveness of cholesterol lowering interventions, and how this information could be interpreted in a rational approach of cholesterol management in general practice. DESIGN:A systematic review of the literature. SETTING:No restriction on setting. ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech.52.9.586
更新日期:1998-09-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the representativeness of survey participants by systematically comparing volunteers in a national health and sexuality survey with the Australian population in terms of self reported health status (including the SF-36) and a wide range of demographic characteristics. DESIGN:A cross sectional...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.56.10.748
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:This study is the first to examine the relationship between gender and self-assessed health (SAH), and the extent to which this varies by socioeconomic position in different European welfare state regimes (Liberal, Corporatist, Social Democratic, Southern). METHODS:The EUROTHINE harmonised data set (based o...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2007.070292
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Antiretroviral therapy (ART) initiation is now recommended irrespective of CD4 count. However data on the relationship between CD4 count at ART initiation and loss to follow-up (LTFU) are limited and conflicting. METHODS:We conducted a cohort analysis including all adults initiating ART (2008-2012) at three...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
doi:10.1136/jech-2015-206629
更新日期:2016-06-01 00:00:00
abstract:STUDY OBJECTIVE:The main cause of breast cancer remains unknown. Numerous causal factors or predisposing conditions have been proposed, but account for only a small percentage of the total disease. The current search for multiple causes is unavailing. This report explores whether any single aetiological agent may be re...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech.54.11.851
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Policies to increase Australian Indigenous children's participation in preschool aim to reduce developmental inequities between Indigenous and non-Indigenous children. This study aims to understand the benefits of preschool participation by quantifying the association between preschool participation in the y...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2020-214672
更新日期:2020-12-08 00:00:00
abstract:OBJECTIVE:To estimate the protective effect of storing firearms locked or unloaded, or both, on the risk of suicide by firearms among people with relatively low intention to die. DESIGN AND SETTING:Cross sectional survey. The 1993 National Mortality Followback Survey of 22 957 deaths in the United States, representing...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech.2003.017343
更新日期:2004-10-01 00:00:00
abstract::The outlook for patients with lung cancer is poor, so an accurate estimation of prognosis will underpin treatment decisions and allow patients to make personal plans for the future. However, evidence suggests that there is a variation between doctors in their predictions of outcomes and also they tend to be over-optim...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2005.044917
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Efforts to end preventable newborn deaths will fail if the poor are not reached with effective interventions. To understand what works to reach vulnerable groups, we describe and explain the uptake of a highly effective community-based newborn health intervention across social strata in Asia and Africa. MET...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2014-204685
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:There are substantial socioeconomic inequalities in functional limitations in old age. Resilience may offer new insights into these inequalities by identifying constellations of factors that protect some individuals from developing functional limitations despite socioeconomic adversity. METHODS:Data from 19...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-211736
更新日期:2019-06-01 00:00:00
abstract:STUDY OBJECTIVE:Several studies have reported an association between income inequality and increased mortality, but few have used net income data, controlled for individual income, or evaluated sensitivity to the choice of inequality measure. The study tested the hypotheses that people in regions of Britain with the gr...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.56.6.436
更新日期:2002-06-01 00:00:00