Abstract：
:This article describes a method for evaluating some of the medical, economic, and personal consequences of different policies of monitoring patients for various disorders. The problem is difficult because it is dynamic. Most conditions develop over time, and in many cases the sensitivity of the test as well as the cost of treatment and the prognosis of the patient depend on how far the disorder has progressed at the time the test is performed. This model incorporates all these factors and enables one to estimate the consequences of applying several tests in different orders and frequencies. The most important assumption in the model is that the outcomes are functions of the earliness of detection (as defined in Figure 3). Failure of this assumption can sometimes be corrected for, but the equations are considerably more complicated and the estimation of parameters more difficult. The progression assumption, that once a particular condition is detectable it is always detectable, is a strong assumption that does not admit the possibility of random false-negative test results. The presence of random false-negative results, however, can be tested for and a random false-negative rate can be included in the model if this is important. This model, like any model, is limited by how well the assumed functional forms (for example, the functional form of the occult interval) represent the actual functional relationships, and by the quality of the data used for estimation of parameters. In some cases, such as screening for breast cancer, good data are available and different functional forms can be tried. In the case of most monitoring tests, however, good data are not currently available. The strength of the model is that it can be used to analyze rather complicated problems. Its main role is to provide general insights, to identify what data should be collected, and to suggest how these data can be used.
journal_name
Clin Lab Medjournal_title
Clinics in laboratory medicineauthors
Eddy DMsubject
Has Abstractpub_date
1982-12-01 00:00:00pages
851-70issue
4eissn
0272-2712issn
1557-9832journal_volume
2pub_type
杂志文章abstract：:Disease prevention requires sociopolitical change, which in turn requires the participation of those for whom the change is intended, including demographic groups at high risk for disease, appropriate governmental authorities, and essential health care personnel. Multiparous women of lowest socioeconomic status, the d...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2004.05.018
更新日期：2004-12-01 00:00:00
abstract：:The most efficacious and practical means of diagnosing human schistosomiasis is based on the detection of infection-specific antibodies. Because of their high sensitivity, antibody assays remain the most practical assays for epidemiologic studies and patient management. Initial screening may be performed in the field ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1991-12-01 00:00:00
abstract：:I have reviewed many of the methods available for the assessment of fetal lung maturity. The difficulty of using diagnostic tests for diseases of low prevalence has been discussed. By reviewing the nature of the amniotic fluid surfactant material, and some of the principles underlying analytical methods, the bases of ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:The myelodysplastic syndromes are bone marrow stem cell disorders that result in disorderly and ineffective hematopoiesis. They are prognostically heterogenous. Approximately one third of cases evolve to acute myeloid leukemia. Many additional cases terminate in severe bone marrow failure. The French-American-British ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1990-12-01 00:00:00
abstract：:The search for clinical outcomes associated with antiphospholipid antibodies (aPL) has been ongoing for a decade. This article focuses on the clinical use of tests for the detection of aPL. A review of the current thinking regarding the pathophysiology of antiphospholipid syndromes is relevant to the discussion of dif...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1995-03-01 00:00:00
abstract：:Biochemical prenatal screening was initiated with the use of maternal serum alpha fetoprotein to screen for open neural tube defects. Screening now includes multiple marker and sequential screening protocols involving serum and ultrasound markers to screen for aneuploidy. Recently cell-free DNA screening for aneuploid...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2016.01.004
更新日期：2016-06-01 00:00:00
abstract：:Automated image processing analysis for leukocyte differential counting started 30 years ago principally as a mimic of the traditional microscopic method. Several types of systems were used in the 1970s and 1980s. In the late 1990s, two new image processing systems were developed with new technology for cell image ana...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-2712(03)00076-3
更新日期：2002-03-01 00:00:00
abstract：:The antiphospholipid syndrome (APS) is an autoimmune disorder presenting with tissue injury in various organs attributed to large or small vessel thrombosis or, in some instances, possible nonthrombotic inflammatory mechanisms, associated with in vitro evidence of antibodies to certain proteins, or proteinphospholipid...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2009.06.001
更新日期：2009-06-01 00:00:00
abstract：:Advances in computing speed and power have made a pure digital work flow for pathology. New technologies such as whole slide imaging (WSI), multispectral image analysis, and algorithmic image searching seem poised to fundamentally change the way in which pathology is practiced. This article provides the practicing pat...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2012.07.006
更新日期：2012-12-01 00:00:00
abstract：:Revolutionary changes in the computer industry brought about in part by the introduction of personal computers are now reaching into clinical laboratories everywhere. Although the true justification for any computer tool may be an intangible one such as improvement in service, such tools can typically be cost justifie...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章
doi：
更新日期：1985-12-01 00:00:00
abstract：:Vitamin D has been associated with many health conditions. Because of widespread deficiency in the general population, laboratory testing of vitamin D has increased exponentially in recent years. Currently, 25-hydroxyvitamin D (25[OH]D) is considered the best marker of vitamin D status. Automated immunoassays and tand...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2018.05.007
更新日期：2018-09-01 00:00:00
abstract：:At the start of the twenty-first century, a dramatic change occurred in the clinical laboratory community. Concepts from Metrology, the science of measurement, began to be formally applied to clinical laboratory field methods, resulting in a new appreciation of metrological calibrator traceability. It is a change beca...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2016.09.010
更新日期：2017-03-01 00:00:00
abstract：:Simple, inexpensive procedures for rapid identification of the common bacterial pathogens are outlined in detail. When the tests are judiciously applied, most isolates can be identified within minutes or hours, and strains that require more extensive testing for accurate identification will be recognized. ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章
doi：
更新日期：1985-03-01 00:00:00
abstract：:Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a rapid, reliable, and high-throughput diagnostic tool for the identification of microorganisms. The technology is unique in clinical microbiology, allowing laboratories to definitively identify bacterial and fungal isolates...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2013.03.001
更新日期：2013-09-01 00:00:00
abstract：:Respiratory viruses continue to be major causes of morbidity and mortality. Currently available chemotherapy is limited to oral amantadine for uncomplicated influenza A and aerosolized ribavirin for respiratory syncytial virus (RSV) infections. Amantadine is also efficacious for chemoprophylaxis of influenza A virus i...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1987-12-01 00:00:00
abstract：:Direct-to-consumer genetic testing came on the scene 2 decades ago as a means for allowing consumers to access their genetic information without the involvement of a physician or genetic counselor. Results are delivered directly to the consumer, often leading to misinterpretation and needless medical interventions or ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2019.11.003
更新日期：2020-03-01 00:00:00
abstract：:Electron microscopy offers substantial aid in the diagnosis of gastrointestinal tract tumors, especially small-cell carcinoma and enterochromaffin-cell tumors. Tumors that are most difficult to classify by light microscopy--that is, poorly differentiated ones--may also have ultrastructural features by which the cell o...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章
doi：
更新日期：1987-03-01 00:00:00
abstract：:Formal medical and public health microbiology (MPHM) fellowship programs play a key role in preparing future clinical microbiology laboratory directors for their leadership and management responsibilities. Given the continually evolving MPHM field, fellowships must remain adaptable to changes in the field, providing t...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2020.08.009
更新日期：2020-12-01 00:00:00
abstract：:With the US Food and Drug Administration's recent label change of warfarin to include genetic testing for warfarin sensitivity, manufacturers are developing assays, and laboratories are offering testing. This article describes the genetic variants for which testing is available. Current technologies and assays are com...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2008.09.001
更新日期：2008-12-01 00:00:00
abstract：:The pathologist, by virtue of his or her observations and documentation of injuries with concomitant attempts to discern patterns of injury and correlate autopsy findings with investigative details, will often play an integral and primary role in the death investigation process. The information gleaned during this pro...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1998-06-01 00:00:00
abstract：:The improvement of quality in clinical care can greatly benefit form continuous benchmarking with information based on laboratory data. To be most effective, the information is best provided in the form of real-time disease management decision support. Such an approach requires advances in the implementation of hospit...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1999-12-01 00:00:00
abstract：:The era of prenatal screening for serious birth defects began in the 1970s with the discovery that amniotic fluid and maternal serum levels of alpha-fetoprotein (AFP) were increased in pregnancies affected by fetal open neural tube defects. Since then, prenatal screening has become a part of routine obstetric care. In...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/s0272-2712(03)00032-5
更新日期：2003-06-01 00:00:00
abstract：:Granulocytic sarcoma is a variant presentation of acute myeloblastic leukemia, occurring in extramedullary locations. It is uncommon, but it may occur at any site and at any age, which necessitates its inclusion in the differential diagnosis of all undifferentiated tumors. Histology, touch-imprint cytology, cytochemis...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1990-12-01 00:00:00
abstract：:An obvious advantage of a combined PAP and PSA measurement is the increased sensitivity of detection. Furthermore, the use of both markers in monitoring patients with prostatic carcinoma offers the advantage of a greater number of patients with objective parameters for follow-up. ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1993-03-01 00:00:00
abstract：:After more than 6 decades of clinical practice, the transplant community continues to research noninvasive biomarkers of solid organ injury to help improve patient care. In this review, we discuss the clinical usefulness of selective biomarkers and how they are processed at the laboratory. In addition, we organize the...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2018.11.003
更新日期：2019-03-01 00:00:00
abstract：:The category of provider-performed microscopy was defined in the Federal Register to provide a unique regulatory approach for bright-field and phase-contrast microscopy performed by a physician, dentist, or midlevel practitioner examining labile specimens. A CLIA certificate for this category of testing is available, ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章
doi：
更新日期：2001-06-01 00:00:00
abstract：:This article attempts to define and identify sources of variation in laboratory analysis that occur predominantly "away" from the analytic bench. Problems in the derivation and application of reference ranges are reviewed and sources of non-analytic error are "located" within the entire testing cycle. Reference source...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章
doi：
更新日期：1986-12-01 00:00:00
abstract：:Adenocarcinoma of the small intestine is relatively rare in comparison to colorectal carcinoma. Adenocarcinoma of the small intestine arises through the adenoma-carcinoma sequence in the colon. However, adenocarcinomas arising in the background of inflammatory bowel disease develop through the dysplasia-carcinoma sequ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2013.08.007
更新日期：2013-12-01 00:00:00
abstract：:The coccidians Cryptosporidium spp, Cyclospora cayetanensis, and Cystoisospora belli and the flagellate Giardia duodenalis are pathogenic protozoa associated with gastrointestinal manifestations. Diagnosis relies heavily on microscopy, and although ova-and-parasite examinations can detect Giardia and Cystoisospora, Cr...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2015.02.010
更新日期：2015-06-01 00:00:00
abstract：:An ideal immunohistochemical screening panel would be one in which each antibody is 100% sensitive and specific for the target cell type (e.g., markers for epithelial neoplasms, lymphomas, sarcomas, etc.). Anyone who has practiced immunochemistry is well aware that this situation does not exist. High sensitivity is hi...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1990-03-01 00:00:00
