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. , .
-, 2007
1113+6
618.1/.2-073.432.19 57.16 63
1113+6 . . . , . -. -, , 2007 . 144 .
ISBN 978-5-9676-0093-0
. , . , . , 2007 . , 2007 .
- . , , , . - , - . -, , .
C 3
C
7
1.
....................................................................................... 11 .......................................... 12 .............. 13- - ..................................................................................... 14 ................................ 15 ....................................................................... 16 ......................................................................................................... 18 , (UK National Screening Committee) ............................... 21 , ........... 24 . ........................................................ 24 ...................................................................................................... 28
2. Rosalinde SniJders, Kypros Nicolaides .........................................................29
...................................... 29 ............................................. 33 .... 36 ..................................... 42 ...................................................................................................... 66
3. Victoria Heath, Kypros Nicolaides ...............................................................73
................................................................................................. 69
, ............................................. 11
. .....................................................................................................6 ..............................................................
4 1113+6
................................................................................................. 82 ...................................................................................................... 94
4. Athena Souka, Constantin von Kaisenberg, Kypros Nicolaides ..............97
...................................................................................... 98 , .......... 100 ................................................................................................ 112 ........ 115 .................................................................................................... 120
5. Neil Sebire, Kypros Nicolaides .................................................................... 123
.................... 124 ................ 125 ...................... 127 ............................................................................................... 134 .................................................................................................... 140
6 1113+6
1866 - 21, , , , . 90- , - - . - 21, 10- 13- , 75% - - - 5%. - - ( ) - 1013 , - 8590%. 2001 , 10- 13- 6070% 21 -. - 21 95% .
, - 21, - - , , , .
, - 1113+6 ,
7
, - , - .
, - , , - 1113+6 , - . Fetal Medicine Foundation , - . - 1113+6 - , -, , .
, , *. - . , -, Fetal Medicine Foundation, - - - - .
* . . . . . - / . ., - . . , 1997.
8 1113+6
Fetal Medicine Foundation (FMF), - , , , . Fetal Medicine Foundation - - , . - FMF . - 1113+6 - , FMF; FMF ; FMF , - , , - - FMF .
- . 5 FMF - 3 .
21 1866 , - . 1990- - - 10- 13- - . - -. , , , , -
9
1013 , 75% , , - 5%.
1990- , - ( ) - 1013 . , - - - -. 8590%. 2001 - . 21 95% .
- 1113 . . - - . , - .
1113 , , . ,
10 1113+6
, - , - -.
1 11
1
- , , , - , . -, , - - . , - , - . , , - .
, , - , , - . - .
12 1113+6
- , , - , , - . - , , , - , - . , - , () - .
- , - . , , , , .
() - . - , . , - , - , . , , - .
1 13
.
(sensitivity) - , - . , (specifi city) - , .
- :
1.
a b
c d
: a - b - c - d -
- , :
(a / (a+c) ) 100%
14 1113+6
- :
(d / (b+d) )100%
, . - .
- -
-- - . - . - ( -- ) - - . - , - . - , , - , ( ), 1% . - (UK National Screening Committee) - 5% .
, - - , - .
1 15
- (predic-tive value). - (positive predictive value) : a / (a+b). - (negative predictive value) - : d / (c+d).
- . , , , - .
(prevalence) , (+b), (a+b+c+d) :
=(+b)/ (a+b+c+d)
, - , -. , , , , . -, , -. -, , , -, -.
16 1113+6
- (likelihood ratio), , , - , . (6070%), , - . - . - . - (positive likelihood ratio, + LR) -, - . (negative likelihood ratio, LR) -, .
- : (a/(a+c)) / (b/(b+d)), : / (100%--).
-, . - (100%-) - , -, .
1 17
: (c/(a+c)) / (d/(b+d)), : (100%-) / .
, . - (100%--) , - .
2. :
21
107 59 a + b=166
212 9272 c + d=9484
+ = 319 b + d = 9331
= (a/(a+c)) 100% =33,5% = (d/(b+d)) 100% = 99,4%
(+) = = /(100%-) = 33,5%/(100% 99,4%) = 55,8 () = (100%-) / = (100% 33,5%)/99,4% = 0,67
, - - 55,8, 0,67. , - , , 1 1000 (0,1%).
18 1113+6
5,58% (0,1% 55,8), - 0,067% (0,1% 0,67) 1 1493. 4.
, - , . , , - , - .
. - , , , - 35% , -.
, - . , - - , -, , .
-, .
1 19
, - . , - , , , . - .
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- , - . , , - . , - - - . - , , . , - .
, .
20 1113+6
, - , , - -. - , (. ), , . . , - 225 974 15 000 , - 5500 . , 220 . , - , , .
- , - , - --. , - . , - . , - -. - , - . .
1 21
, , .
3.
. , . . - - , -.
- - - . , - . , . - . - .
, (UK NATIONAL SCREENING COMMITTEE)
:
22 1113+6
/
/ ; , - , - ; , - ; - , - , .
, , ; -, - , ; ; -, - , . .
- . - - - -
1 23
, .
- - - . , (, - - ), - . - . (, , ) . , - , . - (, , , , - ) - . - . - - , , - . - , .
24 1113+6
- .
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1 25
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