I share your interest in screening for silent underlying disease that can lead to
catastrophic illness without warning. Isn't that the very kind of condition we
should be scrrening for? Medicine so far has done a poor job of screening for
carotid and aneurysmal disease. It's no wonder the proprietary agencies are
popping up to fill the void. I applaud your studies to define further clinical
factors which may identify who should be screened. Can you give the reference
where you have published data?
Rob Lowell, MD, FACS
Horizon Vascular Surgery, P.C.
Joanne Spindel, RDCS, RVT , Technical Lab Director of Vascular wrote:
> Hi, Joanne Spindel here, I
> I also have an interest in carotid screenings; which primarily has been
> research driven to ask the question: What risk factors could delineate
> patients at risk for stroke and cardiac atherosclerosis. Our screenings
> were free, criteria was developed and validated in our lab, Our Medical
> Director Dr. Russell Samson, MD, RVT interpretated the results. We also
> developed a computer software program to generate reports. ICAVL lab with
> RVT's. (can give you more info if you like). Our findings have been
> published and we hope to have a follow paper next year.
> My experience: In the past we were looking for an RVT without luck and
> ended up hiring a girl who had graduated from UDS and was working at Life
> Line Screenings. She could do ABI's and limited images of the AO and
> carotids. Not even complete exams and had limited knowledge of any kind of
> criteria and guideline. Just basically could take a picture. I might have
> seen their report once but don't remember was on it. Based on my
> experience. this leads me to ask, how can you determine an accuracy rate
> when your not sure what is accurate?
> My question to LifeLine Screenings may be redundant with Bill J. but I've
> always wondered:
> -What carotid stenosis ranges do you use and are they uniform throughout
> the company?
> - What do you classify as a positive study and/or significant stenosis?
> - Who's criteria do you follow and how is it validated?
> - What do you base your accuracy rate on?
> - What is your protocol for screening and do you take velocity measurements,
> 2D measurements and in what scan plane? Do you take BP's, listen to bruits,
> have a medical questionnaire?
> - Who interprets your studies and do they review the tape?
> - How qualified are your technologists at these screenings? How trains them?
> - Do you offer guidelines and protocols for scanning? Would you be open to
> sharing them?
> I only mean to gather more clinical knowledge for an inquisitive mind.
> Joanne Spindel, RDCS, RVT
> Technical Director
> Vascular and Surgery Associates of Sarasota