Objective: Electronic fetal heart rate monitoring has an unacceptable false-positive nonreassuring rate, which results in an excess of operative interventions.
The model predicts that the number of cases prevented by intervening is greater than the excess of cases after intervention, giving an overall impact in clinical cases (across all age classes) ranging from 0.4% to 6.8%.
We retrieved data on study size, type of intervention, excess weight loss (EWL) percentage, outcomes at 1-year follow-up, 30-day mortality, and diabetes, hypertension, and lipid disease resolution percentages at the minimum of 1-year follow-up.
Adjusting for sex in the primary analysis to account for the slight excess of boys in the intervention arm did not alter the results.
The authors hypothesised that this might be attributable to an observed excess of cancers in the intervention arm, possibly due to over diagnosis in this age group, or the existence of a subgroup of women with a long sojourn time.
Patients monitored BP at home daily for the first 4 weeks; BP in excess of 160/100 mmHg required intervention, with stability below that level for 3 days required for additional treatment.
To take account of the excess of cancers in the intervention arm due to earlier diagnosis, the probability (p) of each screen-detected cancer remaining asymptomatic to the end of the follow-up period (31.12.1999 or date of death) was calculated using the formula p(t> n)= e− λn where 1/ λ is the mean sojourn time (MST), assuming the sojourn time to be exponentially distributed (Paci et al, 2004).
In their critique of Mitt Romney, GOP leaders fail to recognize that the only thing that has ever moderated the excesses of capitalism is some form of intervention by government, leading to regulations intended to reduce its destructive impacts (the "vulture" part).
While fieldwork is continuing, there is likely to remain an excess of breast cancers in the intervention arm due to advancement of diagnosis.
In the Canadian trials there is an 11 to 14% excess of all cancers in the intervention arm at 13 years of follow-up, largely of DCIS, suggesting the existence of overdiagnosis.
