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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
5
|
| pubmed:dateCreated |
1984-12-7
|
| pubmed:abstractText |
We report here an evaluation of a program for thalassemia-disease prevention, comprising education, population screening for heterozygotes, and reproductive counseling; the evaluation includes cost analysis. A preprogram survey in 1978 of 3,247 citizens in the high-risk communities (85% were high-school students) showed that 88% favored a program but that only 31% considered fetal diagnosis as an acceptable option. Screening in high school or before marriage was preferred by 56%. In a 25-month period (December 1979-December 1982), we screened 6,748 persons, including 5,117 senior high-school students, using MCV/HbA2 indices. The participation rate was 80% in the high-school group. The frequency for beta-thalassemia heterozygosity was 4.7% with 10-fold variation among ethnic groups at risk; the overall frequency for all variants found was 5.4%. We surveyed 60 carriers and 120 noncarriers after screening high-school students (response rate 77%): most carriers told parents (95%) and friends (67%) the test result; and 38% of the carriers' parents (vs. 18% of the noncarriers' parents) were also screened. Carriers would ascertain their spouses' genotype (91%) and approved uniformly (95%) the high-school screening experience and its goal. We performed 11 fetal diagnoses in a 25-month interval (greater than 75% participation in target population) either by fetoscopy and globin-chain analysis or by amniocentesis and genomic DNA analysis; two of three affected fetuses were aborted at parental request, there was one spontaneous abortion (after fetoscopy), and seven live births. The at-risk couples claimed pregnancy would not be contemplated without the fetal-diagnosis option. We analyzed economic costs of the program: cost per case prevented is approximately equal to $ 6,700, slightly less than cost-per-patient-treatment-year or about 4% of undiscounted treatment cost incurred in the first 25 years of life for an affected individual. These findings indicate: collective acceptance of the program, appropriate attitudes among carriers, general acceptance and efficacy of fetal diagnosis, and global cost-effectiveness.
|
| pubmed:commentsCorrections |
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-4418237,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-4458903,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-4775114,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-517521,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-6106748,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-6107784,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-6107785,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-6108439,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-6109998,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-6300677,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-6407302,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-644337,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-6891613,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-709470,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-7388536,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-7401125,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-7424973,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-7448429,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-840535,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-840547,
http://linkedlifedata.com/resource/pubmed/commentcorrection/6496471-914280
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Sep
|
| pubmed:issn |
0002-9297
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
36
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
1024-38
|
| pubmed:dateRevised |
2009-11-18
|
| pubmed:meshHeading |
pubmed-meshheading:6496471-Adolescent,
pubmed-meshheading:6496471-Adult,
pubmed-meshheading:6496471-Costs and Cost Analysis,
pubmed-meshheading:6496471-Female,
pubmed-meshheading:6496471-Genetic Counseling,
pubmed-meshheading:6496471-Heterozygote Detection,
pubmed-meshheading:6496471-Humans,
pubmed-meshheading:6496471-Mass Screening,
pubmed-meshheading:6496471-Pregnancy,
pubmed-meshheading:6496471-Prenatal Diagnosis,
pubmed-meshheading:6496471-Thalassemia
|
| pubmed:year |
1984
|
| pubmed:articleTitle |
Beta-thalassemia disease prevention: genetic medicine applied.
|
| pubmed:publicationType |
Journal Article,
Research Support, Non-U.S. Gov't
|