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Biomedical subjects

J Chamberlain

Publications and source records attributed to J Chamberlain.

At least 199 records · Page 11Linked to original sources

Validity of clinical examination and mammography as screening tests for breast cancer.

This study is aiming to determine the validity and observer variability of clinical examination and mammography as screening tests for breast cancer. Women over the age of forty are given two independent clinical examinations of the breasts, and mammograms are taken and read independently by two radiologists. This paper presents the results of screening the first 1215 women to be enrolled in the study. At their first screening attendance, 231 women (19%) were referred for surgical opinion, 119 (9-8%) underwent biopsy, and cancer was diagnosed in 17 (1-4%). 2 further cancers were diagnosed in the ensuing six months among women who had been negative on initial screening, representing a false-negative rate of 2 out of 19 (11%). Clinical examination resulted in 189 referrals (15-6%), 90 biopsies (7-4%), and detected 11 cancers; corresponding figures for mammography were 76 referrals (6-3%), 55 biopsies ((4-5%), and 14 cancers. Observer variability was greater for clinical examination than for mammography. These early results suggest that as a screening test mammography compares favourably with clinical examination, but both tests are necessary if many false negatives are to be avoided.

Adult↗

The relationship between ultrasound assessment and angiography in occlusive arterial disease of the lower limb.

The Doppler ultrasound technique has been used to assess the haemodynamics of the peripheral circulation in patients with arterial disease. Using this method the resting pressure index and the response after exercise of the systolic pressure at the ankle was determined in 62 limbs. Following exercise, four patterns of abnormal response to exercise were found and graded in severity from 1 to 4. A single aorto-iliac lesion was associated with a normal or slightly reduced resting pressure index but with a severe reduction of pressure (grade 3-4) after exercise. A single femoropopliteal lesion was usually associated with a low resting pressure index but only a slight (grade 1-2) fall after exercise. A low resting pressure index and a severe postexercise grade were found in patients with multiple occlusions. Disease of the profunda femoris artery was associated usually with both a low resting pressure index and a grade 3-4 post-exercise curve.

Adult↗

Acceptability of the cytopipette in screening for cervical cancer.

A randomized controlled trial was carried out in which the acceptability of screening for cervical carcinoma in situ by a postal 'do-it-yourself' method--the cytopipette--was compared with that of an invitation to attend a clinic or see a general practitioner for the conventional cervical scrape examination. In parallel with this, a sociological study of women who had been invited by both methods was undertaken in which information was obtained from responders and non-responders on attitudes to health care. The results show that, while the pipette was used by a greater proportion of women overall than the scrape examination, its acceptance by women most at risk of the disease is still not high. It is concluded that, taking into account the relative merits of the two methods as screening tests, as well as their acceptability and cost, the postal pipette may be useful in some circumstances, such as areas where clinical resources are limited, and as a second approach to women who have not taken up the offer of a scrape examination.

Adolescent↗