| Electronic fetal monitoring as a public health screening program: the arithmetic of failure. | |
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MedLine Citation:
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PMID: 21099609 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Electronic fetal monitoring has failed as a public health screening program. Nevertheless, most of the four million low-risk women giving birth in the United States each year continue to undergo this screening. The failure of this program should have been anticipated and thus avoided had the accepted principles of screening been considered before its introduction. All screening tests have poor positive predictive value when searching for rare conditions such as fetal death in labor or cerebral palsy. This problem is aggravated when the screening test does not have good validity as is the case with electronic fetal monitoring. Because of low-prevalence target conditions and mediocre validity, the positive predictive value of electronic fetal monitoring for fetal death in labor or cerebral palsy is near zero. Stated alternatively, almost every positive test result is wrong. To avoid such costly errors in the future, the prerequisites for any screening program must be fulfilled before the program is begun. |
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Authors:
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David A Grimes; Jeffrey F Peipert |
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Publication Detail:
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Type: Editorial |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 116 ISSN: 1873-233X ISO Abbreviation: Obstet Gynecol Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-24 Completed Date: 2011-01-04 Revised Date: 2011-05-03 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 1397-400 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cardiotocography* Cerebral Palsy / diagnosis False Positive Reactions Female Fetal Death / diagnosis Fetal Monitoring* Humans Infant, Newborn Neonatal Screening* Predictive Value of Tests Pregnancy Risk Factors Sensitivity and Specificity |
| Comments/Corrections | |
Comment In:
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Obstet Gynecol. 2011 Apr;117(4):986; author reply 986-7
[PMID:
21422874
]
Obstet Gynecol. 2011 Mar;117(3):730; author reply 730-1 [PMID: 21343780 ] Obstet Gynecol. 2011 Mar;117(3):731; author reply 731-2 [PMID: 21343782 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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