Abstract:
OBJECTIVE:To evaluate the cost-effectiveness of human papillomavirus (HPV) DNA testing as a primary screening test in combination with cervical cytology in women aged 30 years or more. METHODS:A state-transition mathematical model was used to simulate the natural history of HPV and cervical cancer in a cohort of U.S. women. Strategies included no screening and screening at different frequencies with conventional cytology, liquid-based cytology with HPV testing used for triage of equivocal results, and HPV DNA testing and cytology in combination after women had reached the age of 30. Outcomes measured included cancer incidence, life expectancy, lifetime costs, and incremental cost-effectiveness ratios. RESULTS:The estimated reduction in lifetime risk of cervical cancer varies from 81% to 93% depending on the screening frequency, type of cytology, and test strategy. Every 3-year screening with liquid-based cytology administered to women at all ages and every 3-year screening using HPV DNA testing and cytology in combination administered to women aged 30 years or more provide equivalent or greater benefits than those provided by annual conventional cytology and have incremental cost-effectiveness ratios of US dollars 95300 and US dollars 228700 per year of life gained, respectively. In comparison, annual screening with HPV DNA testing and cytology in combination provides only a few hours of additional life expectancy and has a cost-effectiveness ratio of more than Us dollars 2000000 per year of life gained. CONCLUSIONS:For women aged 30 years and more, every 2- or 3-year screening strategy that uses either HPV DNA testing in combination with cytology for primary screening or cytology with reflex HPV DNA testing for equivocal results will provide a greater reduction in cancer and be less costly than annual conventional cytology.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Goldie SJ,Kim JJ,Wright TCdoi
10.1097/01.AOG.0000120143.50098.c7subject
Has Abstractpub_date
2004-04-01 00:00:00pages
619-31issue
4eissn
0029-7844issn
1873-233Xpii
103/4/619journal_volume
103pub_type
杂志文章abstract:BACKGROUND:Umbilical vascular coiling may function as a rudimentary pump that facilitates venous return from the placenta. CASES:Three consecutive twin gestations with twin-twin transfusion syndrome were evaluated prospectively at delivery. The birth weights and umbilical coiling indices of donor and recipient twins w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00057-4
更新日期:1997-05-01 00:00:00
abstract::Immediate maternal and fetal cardiovascular responses to different doses of nicotine and carbon monoxide were studied in 24 pregnant smokers. A noninvasive pulsed Doppler ultrasound technique was used for measuring fetal blood flow in the descending thoracic aorta, the intra-abdominal part of the umbilical vein, and i...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to evaluate the value of neural network-directed review of smears determined to contain atypical squamous (glandular) cells of undetermined significance to identify those cases most likely to be associated with cervical intraepithelial neoplasia. METHODS:One hundred sixty smea...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00017-9
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVE:Preoperative evaluation for pregnancy at our institution lacked standardization among individual health care providers and surgical services. This pilot project aimed to improve assessment for pregnancy before scheduled outpatient gynecologic surgical procedures. The Pregnancy Reasonably Excluded Guide incorp...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002917
更新日期:2018-11-01 00:00:00
abstract::All 119 medical schools in the United States provided information for a study of academic manpower conducted by the Association of Professors of Gynecology and Obstetrics (APGO). The average number of full-time faculty members per medical school is 13.2, with 2 positions vacant per school. Subspecialists are concentra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-05-01 00:00:00
abstract::The phenomenon of adolescent childbearing is complex and far reaching, affecting not only the adolescents but also their children and their community. The prevalence and public health effect of adolescent pregnancy reflect complex structural social problems and an unmet need for acceptable and effective contraceptive ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002632
更新日期:2018-05-01 00:00:00
abstract::The purpose of the present retrospective study was to examine the relationship between hypertension and abruptio placentae. Two hundred sixty-five consecutive cases of abruption were reviewed, with an emphasis on the occurrence and severity of hypertensive disease. The results confirm a close relationship between abru...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract:OBJECTIVE:To assess the effect of antenatal and postnatal corticosteroids on head circumference growth and weight gain from birth to discharge. METHODS:We conducted a retrospective analysis of nonanomalous newborns admitted to the neonatal intensive care unit from 23 to 34 6/7 weeks of gestation. Independent variables...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01657-x
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:To identify risk factors for febrile morbidity after hysterectomy for nonmalignant indications. METHODS:We performed a retrospective cohort study of 686 women who had a hysterectomy between January and September 1997 by abdominal (n = 408), laparoscopic-assisted vaginal (n = 90), or vaginal (n = 188) approac...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000109219.24211.30
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Renal cell carcinoma is a potentially fatal tumor that occasionally presents during pregnancy. Based on our experience with three patients and a review of the recent cases in the literature, we believe there has been a change in presentation of this lesion over that described in previous reviews. CASES:Two ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:To determine whether the prevalence of normal endometrial cells in Papanicolaou smears of women with and those without endometrial carcinoma or hyperplasia differs significantly. METHODS:Papanicolaou smears of women with biopsy-proved endometrial hyperplasia or carcinoma diagnosed between 1990 and 1998 were ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)01038-3
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:To identify smartphone menstrual cycle tracking applications (apps) and evaluate their accuracy, features, and functionality. METHODS:In this systematic evaluation, we searched the Apple iTunes store for free menstrual cycle tracking apps for patient use. We considered an application accurate if menstrual cy...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001444
更新日期:2016-06-01 00:00:00
abstract::To characterize maternal thermal balance during pregnancy, the authors recorded the thermal response to moderate weight bearing exercise stress in four aerobically conditioned pregnant women. Studies were performed in a climate-controlled environment in each trimester of pregnancy and postpartum after modifying the ex...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract::Oophorectomy is not always performed at the time of vaginal hysterectomy because of technical difficulties encountered in visualizing the ovaries and clamping and ligating the infundibulopelvic ligament. After uterine removal, a method that simplifies the approach involves separating the round ligament along the avasc...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00332-0
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:To estimate the detection rate of abnormalities by transvaginal ultrasound in early pregnancy. METHODS:We prospectively analyzed records of 3592 sequential pregnant women at 10-16 weeks' (singleton) gestation (mean 13 weeks and 2 days). After exclusion of 114 women, there were 3478 women in the study. Each w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)00951-0
更新日期:2000-09-01 00:00:00
abstract::Individuals with Down syndrome have abnormally short long bones. Sonography has previously revealed slightly shortened femurs and thickened nuchal folds in affected second-trimester fetuses. Humeral and femoral lengths and nuchal folds were evaluated in 400 normal second-trimester controls and in 24 consecutive Down s...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199102000-00012
更新日期:1991-02-01 00:00:00
abstract::Postpartum hemorrhage is a common and serious complication of the third stage of labor resulting in anemia and increased morbidity in the puerperium. Administration of uterotonic drugs and suitable mechanical assistance in delivery of the placenta may significantly reduce this hazard. Ergometrine and oxytocin have bee...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-12-01 00:00:00
abstract:OBJECTIVE:To investigate whether pregnancy-induced regulatory T cells are generated specifically for paternal antigens or expanded by hormonal changes and to study regulatory T cell-related mechanisms during pregnancy. METHODS:We used murine models of normal, abortion-prone, and pseudopregnancy to characterize regulat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000284625.10175.31
更新日期:2007-11-01 00:00:00
abstract::The optimal timing for clamping the umbilical cord after birth has been a subject of controversy and debate. Although many randomized controlled trials in term and preterm infants have evaluated the benefits of delayed umbilical cord clamping versus immediate umbilical cord clamping, the ideal timing for cord clamping...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/01.AOG.0000423817.47165.48
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Gigantomastia is a rare and dangerous condition in pregnancy. Although improvement after delivery is likely, postpartum aggravation is possible. To date, various pharmacological approaches have been tried, with only marginal effectiveness. Surgical intervention is often necessary. CASE:A young woman present...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(03)00061-9
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:To estimate the population risks of maternal and infant complications with the birth of macrosomic (at least 4000 g) compared with normal weight infants. METHODS:Term, singleton infants were identified from the state of Washington's birth event records database for 1990. Diagnosis codes from the Internal Cla...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)00224-5
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Serious injury can result from improper use of the birthing bar. CASE:A 31-year-old woman delivered a neonate using a birthing bar for her entire second stage of labor. Shortly after delivery, she experienced bilateral upper extremity weakness from compression of the radial nerve. She was treated with physi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:To compare biopsychologic profiles of women with dyspareunia with a matched no-pain control sample, and to determine whether dyspareunia subtypes based on physical findings have different psychosocial profiles from matched controls. METHODS:One hundred and five women with dyspareunia and 105 matched no-pain ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(98)80136-1
更新日期:1997-10-01 00:00:00
abstract::Multiple studies suggest that health care workers treating human papillomavirus (HPV)-associated conditions may experience occupational exposure to the virus. Case reports describe the development of cancer and other disease in health care professionals at low risk for such conditions except for their work. Despite li...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004021
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:Reducing tobacco use in pregnancy is a public health priority. Brief smoking counseling during prenatal care is effective but generates modest cessation rates. Telephone counseling is an effective smoking cessation method that could offer pregnant women convenient access to more intensive smoking cessation co...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.AOG.0000218100.05601.f8
更新日期:2006-07-01 00:00:00
abstract::The endocrine effects of induction of ovulation with menotropins were studied in 43 patients: 11 with hypothalamic amenorrhea and 32 with the polycystic ovary syndrome. Patients with polycystic ovary syndrome had higher base-line values of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17 beta-est...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-02-01 00:00:00
abstract::The effect of maternal age on the incidence and significance of hydatidiform mole in 2202 patients studied at the Southeastern Regional Trophoblastic Disease Center during 1978 to 1982 is analyzed. Results are compared with a contemporary control group that comprised all types of pregnancy events. A significant increa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract:OBJECTIVE:To assess the risks of congenital varicella syndrome and other birth defects in offspring of women who inadvertently received varicella vaccine during pregnancy or within 3 months of conception. METHODS:Pregnant women inadvertently exposed to varicella vaccine, reported voluntarily, were enrolled in the Preg...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01384-9
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:To estimate whether race or ethnic and socioeconomic strata are independently associated with advanced-stage ovarian cancer-specific survival after adjusting for adherence to National Comprehensive Cancer Network treatment guidelines. METHODS:The design was a retrospective population-based cohort study of pa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000643
更新日期:2015-04-01 00:00:00
abstract::Blood transfusions performed earlier in the 20th century were often accompanied by significant complications. Today, with an increased knowledge of blood type compatibility, the majority of risks have been eliminated. However, hazards still remain. The authors report on a potentially fatal pulmonary disorder caused by...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00