Doug Brunk

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient’s quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient’s quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient’s quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient’s quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient’s quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient’s quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins was 2.1% in adults during nearly 7 years of follow-up, results from a large study showed.

The findings come from a 6.6-year follow-up of patients in the Bonn Vein Study I, a population-based, cross-sectional study conducted in 2000. The study evaluated the incidence of chronic venous disorders in 1,350 men and 1,722 women aged 18-79 years in Bonn, Germany, and in two nearby rural townships. The Bonn Vein Study II, the current analysis, aimed to identify the incidence and risk factors for progression of preexisting chronic venous disease among those in the Bonn Vein Study I, Dr. Felizitas Pannier said at the annual meeting of the American Venous Forum.

Between August 2007 and October 2008, Dr. Eberhard Rabe, of the dermatology department at the University of Bonn, and his associate, Dr. Pannier, contacted all of the Bonn Vein Study I participants and asked them to answer a questionnaire and to undergo clinical examination including a duplex ultrasound. Of the original 3,072 participants, 1,978 responded.

During a mean follow-up of 6.6 years, the incidence of varicose veins was 2.1% per year, with no differences between men and women. The incidence rate increased with age: 1.1% per year for those younger than age 39, 2.0% per year for those aged 40-59, and 2.8% per year for those older than age 59.

The incidence of grade C6 insufficiency was 2% per year, with no differences between men and women. The incidence rate increased with age: 0.6% per year for those younger than age 39, 1.5% per year for those aged 40-59, and 3.3% per year for those older than age 59.

Dr. Pannier reported that over the 6.6 years of follow-up, the prevalence of varicose veins increased from 22.7% to 25.1%, while the prevalence of chronic venous insufficiency rose from 14.5% to 16.0%. She also noted that among participants who had grade C2 insufficiency (simple varicose veins) in the Bonn Vein I study, 19.8% progressed to higher C-classes (functional abnormalities) in the nonsaphenous varicose veins, while 31.8% progressed to higher C-classes in the saphenous varicose veins.

Multivariate analysis revealed that the significant risk factors for progression of venous disease were age (relative risk of 1.02 per year), obesity (RR 3.47), and a swelling sensation (RR 1.68).

Dr. Pannier said that neither she nor Dr. Rabe had any relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins was 2.1% in adults during nearly 7 years of follow-up, results from a large study showed.

The findings come from a 6.6-year follow-up of patients in the Bonn Vein Study I, a population-based, cross-sectional study conducted in 2000. The study evaluated the incidence of chronic venous disorders in 1,350 men and 1,722 women aged 18-79 years in Bonn, Germany, and in two nearby rural townships. The Bonn Vein Study II, the current analysis, aimed to identify the incidence and risk factors for progression of preexisting chronic venous disease among those in the Bonn Vein Study I, Dr. Felizitas Pannier said at the annual meeting of the American Venous Forum.

Between August 2007 and October 2008, Dr. Eberhard Rabe, of the dermatology department at the University of Bonn, and his associate, Dr. Pannier, contacted all of the Bonn Vein Study I participants and asked them to answer a questionnaire and to undergo clinical examination including a duplex ultrasound. Of the original 3,072 participants, 1,978 responded.

During a mean follow-up of 6.6 years, the incidence of varicose veins was 2.1% per year, with no differences between men and women. The incidence rate increased with age: 1.1% per year for those younger than age 39, 2.0% per year for those aged 40-59, and 2.8% per year for those older than age 59.

The incidence of grade C6 insufficiency was 2% per year, with no differences between men and women. The incidence rate increased with age: 0.6% per year for those younger than age 39, 1.5% per year for those aged 40-59, and 3.3% per year for those older than age 59.

Dr. Pannier reported that over the 6.6 years of follow-up, the prevalence of varicose veins increased from 22.7% to 25.1%, while the prevalence of chronic venous insufficiency rose from 14.5% to 16.0%. She also noted that among participants who had grade C2 insufficiency (simple varicose veins) in the Bonn Vein I study, 19.8% progressed to higher C-classes (functional abnormalities) in the nonsaphenous varicose veins, while 31.8% progressed to higher C-classes in the saphenous varicose veins.

Multivariate analysis revealed that the significant risk factors for progression of venous disease were age (relative risk of 1.02 per year), obesity (RR 3.47), and a swelling sensation (RR 1.68).

Dr. Pannier said that neither she nor Dr. Rabe had any relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins was 2.1% in adults during nearly 7 years of follow-up, results from a large study showed.

The findings come from a 6.6-year follow-up of patients in the Bonn Vein Study I, a population-based, cross-sectional study conducted in 2000. The study evaluated the incidence of chronic venous disorders in 1,350 men and 1,722 women aged 18-79 years in Bonn, Germany, and in two nearby rural townships. The Bonn Vein Study II, the current analysis, aimed to identify the incidence and risk factors for progression of preexisting chronic venous disease among those in the Bonn Vein Study I, Dr. Felizitas Pannier said at the annual meeting of the American Venous Forum.

Between August 2007 and October 2008, Dr. Eberhard Rabe, of the dermatology department at the University of Bonn, and his associate, Dr. Pannier, contacted all of the Bonn Vein Study I participants and asked them to answer a questionnaire and to undergo clinical examination including a duplex ultrasound. Of the original 3,072 participants, 1,978 responded.

During a mean follow-up of 6.6 years, the incidence of varicose veins was 2.1% per year, with no differences between men and women. The incidence rate increased with age: 1.1% per year for those younger than age 39, 2.0% per year for those aged 40-59, and 2.8% per year for those older than age 59.

The incidence of grade C6 insufficiency was 2% per year, with no differences between men and women. The incidence rate increased with age: 0.6% per year for those younger than age 39, 1.5% per year for those aged 40-59, and 3.3% per year for those older than age 59.

Dr. Pannier reported that over the 6.6 years of follow-up, the prevalence of varicose veins increased from 22.7% to 25.1%, while the prevalence of chronic venous insufficiency rose from 14.5% to 16.0%. She also noted that among participants who had grade C2 insufficiency (simple varicose veins) in the Bonn Vein I study, 19.8% progressed to higher C-classes (functional abnormalities) in the nonsaphenous varicose veins, while 31.8% progressed to higher C-classes in the saphenous varicose veins.

Multivariate analysis revealed that the significant risk factors for progression of venous disease were age (relative risk of 1.02 per year), obesity (RR 3.47), and a swelling sensation (RR 1.68).

Dr. Pannier said that neither she nor Dr. Rabe had any relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins was 2.1% in adults during nearly 7 years of follow-up, results from a large study showed.

The findings come from a 6.6-year follow-up of patients in the Bonn Vein Study I, a population-based, cross-sectional study conducted in 2000. The study evaluated the incidence of chronic venous disorders in 1,350 men and 1,722 women aged 18-79 years in Bonn, Germany, and in two nearby rural townships. The Bonn Vein Study II, the current analysis, aimed to identify the incidence and risk factors for progression of preexisting chronic venous disease among those in the Bonn Vein Study I, Dr. Felizitas Pannier said at the annual meeting of the American Venous Forum.

Between August 2007 and October 2008, Dr. Eberhard Rabe, of the dermatology department at the University of Bonn, and his associate, Dr. Pannier, contacted all of the Bonn Vein Study I participants and asked them to answer a questionnaire and to undergo clinical examination including a duplex ultrasound. Of the original 3,072 participants, 1,978 responded.

During a mean follow-up of 6.6 years, the incidence of varicose veins was 2.1% per year, with no differences between men and women. The incidence rate increased with age: 1.1% per year for those younger than age 39, 2.0% per year for those aged 40-59, and 2.8% per year for those older than age 59.

The incidence of grade C6 insufficiency was 2% per year, with no differences between men and women. The incidence rate increased with age: 0.6% per year for those younger than age 39, 1.5% per year for those aged 40-59, and 3.3% per year for those older than age 59.

Dr. Pannier reported that over the 6.6 years of follow-up, the prevalence of varicose veins increased from 22.7% to 25.1%, while the prevalence of chronic venous insufficiency rose from 14.5% to 16.0%. She also noted that among participants who had grade C2 insufficiency (simple varicose veins) in the Bonn Vein I study, 19.8% progressed to higher C-classes (functional abnormalities) in the nonsaphenous varicose veins, while 31.8% progressed to higher C-classes in the saphenous varicose veins.

Multivariate analysis revealed that the significant risk factors for progression of venous disease were age (relative risk of 1.02 per year), obesity (RR 3.47), and a swelling sensation (RR 1.68).

Dr. Pannier said that neither she nor Dr. Rabe had any relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins was 2.1% in adults during nearly 7 years of follow-up, results from a large study showed.

The findings come from a 6.6-year follow-up of patients in the Bonn Vein Study I, a population-based, cross-sectional study conducted in 2000. The study evaluated the incidence of chronic venous disorders in 1,350 men and 1,722 women aged 18-79 years in Bonn, Germany, and in two nearby rural townships. The Bonn Vein Study II, the current analysis, aimed to identify the incidence and risk factors for progression of preexisting chronic venous disease among those in the Bonn Vein Study I, Dr. Felizitas Pannier said at the annual meeting of the American Venous Forum.

Between August 2007 and October 2008, Dr. Eberhard Rabe, of the dermatology department at the University of Bonn, and his associate, Dr. Pannier, contacted all of the Bonn Vein Study I participants and asked them to answer a questionnaire and to undergo clinical examination including a duplex ultrasound. Of the original 3,072 participants, 1,978 responded.

During a mean follow-up of 6.6 years, the incidence of varicose veins was 2.1% per year, with no differences between men and women. The incidence rate increased with age: 1.1% per year for those younger than age 39, 2.0% per year for those aged 40-59, and 2.8% per year for those older than age 59.

The incidence of grade C6 insufficiency was 2% per year, with no differences between men and women. The incidence rate increased with age: 0.6% per year for those younger than age 39, 1.5% per year for those aged 40-59, and 3.3% per year for those older than age 59.

Dr. Pannier reported that over the 6.6 years of follow-up, the prevalence of varicose veins increased from 22.7% to 25.1%, while the prevalence of chronic venous insufficiency rose from 14.5% to 16.0%. She also noted that among participants who had grade C2 insufficiency (simple varicose veins) in the Bonn Vein I study, 19.8% progressed to higher C-classes (functional abnormalities) in the nonsaphenous varicose veins, while 31.8% progressed to higher C-classes in the saphenous varicose veins.

Multivariate analysis revealed that the significant risk factors for progression of venous disease were age (relative risk of 1.02 per year), obesity (RR 3.47), and a swelling sensation (RR 1.68).

Dr. Pannier said that neither she nor Dr. Rabe had any relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins was 2.1% in adults during nearly 7 years of follow-up, results from a large study showed.

The findings come from a 6.6-year follow-up of patients in the Bonn Vein Study I, a population-based, cross-sectional study conducted in 2000. The study evaluated the incidence of chronic venous disorders in 1,350 men and 1,722 women aged 18-79 years in Bonn, Germany, and in two nearby rural townships. The Bonn Vein Study II, the current analysis, aimed to identify the incidence and risk factors for progression of preexisting chronic venous disease among those in the Bonn Vein Study I, Dr. Felizitas Pannier said at the annual meeting of the American Venous Forum.

Between August 2007 and October 2008, Dr. Eberhard Rabe, of the dermatology department at the University of Bonn, and his associate, Dr. Pannier, contacted all of the Bonn Vein Study I participants and asked them to answer a questionnaire and to undergo clinical examination including a duplex ultrasound. Of the original 3,072 participants, 1,978 responded.

During a mean follow-up of 6.6 years, the incidence of varicose veins was 2.1% per year, with no differences between men and women. The incidence rate increased with age: 1.1% per year for those younger than age 39, 2.0% per year for those aged 40-59, and 2.8% per year for those older than age 59.

The incidence of grade C6 insufficiency was 2% per year, with no differences between men and women. The incidence rate increased with age: 0.6% per year for those younger than age 39, 1.5% per year for those aged 40-59, and 3.3% per year for those older than age 59.

Dr. Pannier reported that over the 6.6 years of follow-up, the prevalence of varicose veins increased from 22.7% to 25.1%, while the prevalence of chronic venous insufficiency rose from 14.5% to 16.0%. She also noted that among participants who had grade C2 insufficiency (simple varicose veins) in the Bonn Vein I study, 19.8% progressed to higher C-classes (functional abnormalities) in the nonsaphenous varicose veins, while 31.8% progressed to higher C-classes in the saphenous varicose veins.

Multivariate analysis revealed that the significant risk factors for progression of venous disease were age (relative risk of 1.02 per year), obesity (RR 3.47), and a swelling sensation (RR 1.68).

Dr. Pannier said that neither she nor Dr. Rabe had any relevant financial disclosures.

SAN DIEGO – The annual incidence of new trunk varicose veins in adults during 13 years of follow-up is 1.36% results from a large study showed.

There were no differences in the annual incidence rate between men and women, but the risk of developing new trunk varicose veins increased significantly with age. The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, but did not reach significance, perhaps because of the size of the study.

Those are key findings from the Edinburgh Vein Study, one of the first efforts to longitudinally measure the adult incidence of trunk varicose veins and to examine factors which increase the risk of varicose veins.

"There have been several studies conducted throughout the world, which have looked into the prevalence of varicose veins and associated risk factors, but few have examined new disease," Dr. Lindsay A. Robertson said at the annual meeting of the American Venous Forum. "While it is important to know about the prevalence of varicose veins, the design of studies is such that we cannot differentiate between the cause and effect. Therefore, it is important to start with people free of venous disease, [and] look at the risk factors, and then we can determine the true effect of such risk factors on the development of venous disease."

The Edinburgh Vein Study was a population cohort study conducted from 1994 to 1996 in a random sample of 1,566 citizens of Edinburgh, who were between the ages of 18 and 64 years. Dr. Robertson of the University of Edinburgh and her associates invited survivors of that cohort to participate in a 13-year follow-up examination, which included clinical classification of venous disease using CEAP, a duplex scan of leg veins, and measurements of height and weight, as well as a questionnaire for lifestyle risk factors such as mobility at work, smoking, pregnancy, previous treatment for varicose veins, and family history.

From baseline there were 1,446 survivors. Of those, 880 took part in the follow-up study, for a response rate of 60.4%. Of these, 490 were women and 390 were men. Their mean age was 60 years.

Dr. Robertson presented findings from 555 of the 880 participants who had no trunk varicose veins at baseline. Of these 555 participants, 101 developed grade C2 trunk varicose veins in any leg during the 13-year follow-up, for an overall incidence rate of 18.2% and an annual incidence rate of 1.36%. The annual incidence in men and women was similar (1.31% and 1.39%, respectively).

The annual incidence of new trunk varicose veins rose significantly with age, rising 0.73% per year among those aged 18-34 years, 1.23% among those aged 35-44 years, 1.62% among those aged 45-54 years, and 1.93% among those aged 55-64 years.

The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, rising 1.06% per year among those who were underweight, 1.28% among those who were normal weight, 1.41% among those who were overweight, and 1.54% among those who were obese. These differences did not reach statistical significance, "but it’s thought that with higher numbers [of participants], these differences would reach statistical significance," Dr. Robertson said.

An association between the development of new trunk varicose veins and pregnancy was also observed. For example, the annual incidence of new trunk varicose veins was 1.24% among women who had never been pregnant, compared with 2.04% among women who had been pregnant at least four times. This finding was "borderline statistically significant," she said. "But with higher numbers of participants in each group, it’s thought that this would reach statistical significance."

The annual incidence of new varicose veins among participants who reported having a family history of varicose veins (defined as having a mother or father with the condition) was significantly higher compared with those who reported no family history of the condition (1.74% vs. 1.14%, respectively).

There was no significant difference in the annual incidence of new trunk varicose veins among those who reported a history of smoking at baseline compared with those who said that they never smoked (1.32% vs. 1.40%, respectively).

The cumulative incidence of new trunk varicose veins at follow-up was 13% among those who had no reflux at baseline, 23% among those who had deep reflux at baseline, 35% among those who had superficial reflux at baseline, and 42% among those who had deep and superficial reflux at baseline.

The study was funded by Scotland’s Chief Scientist Office. Dr. Robertson said that she had no relevant financial disclosures to make.

SAN DIEGO – The annual incidence of new trunk varicose veins in adults during 13 years of follow-up is 1.36% results from a large study showed.

There were no differences in the annual incidence rate between men and women, but the risk of developing new trunk varicose veins increased significantly with age. The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, but did not reach significance, perhaps because of the size of the study.

Those are key findings from the Edinburgh Vein Study, one of the first efforts to longitudinally measure the adult incidence of trunk varicose veins and to examine factors which increase the risk of varicose veins.

"There have been several studies conducted throughout the world, which have looked into the prevalence of varicose veins and associated risk factors, but few have examined new disease," Dr. Lindsay A. Robertson said at the annual meeting of the American Venous Forum. "While it is important to know about the prevalence of varicose veins, the design of studies is such that we cannot differentiate between the cause and effect. Therefore, it is important to start with people free of venous disease, [and] look at the risk factors, and then we can determine the true effect of such risk factors on the development of venous disease."

The Edinburgh Vein Study was a population cohort study conducted from 1994 to 1996 in a random sample of 1,566 citizens of Edinburgh, who were between the ages of 18 and 64 years. Dr. Robertson of the University of Edinburgh and her associates invited survivors of that cohort to participate in a 13-year follow-up examination, which included clinical classification of venous disease using CEAP, a duplex scan of leg veins, and measurements of height and weight, as well as a questionnaire for lifestyle risk factors such as mobility at work, smoking, pregnancy, previous treatment for varicose veins, and family history.

From baseline there were 1,446 survivors. Of those, 880 took part in the follow-up study, for a response rate of 60.4%. Of these, 490 were women and 390 were men. Their mean age was 60 years.

Dr. Robertson presented findings from 555 of the 880 participants who had no trunk varicose veins at baseline. Of these 555 participants, 101 developed grade C2 trunk varicose veins in any leg during the 13-year follow-up, for an overall incidence rate of 18.2% and an annual incidence rate of 1.36%. The annual incidence in men and women was similar (1.31% and 1.39%, respectively).

The annual incidence of new trunk varicose veins rose significantly with age, rising 0.73% per year among those aged 18-34 years, 1.23% among those aged 35-44 years, 1.62% among those aged 45-54 years, and 1.93% among those aged 55-64 years.

The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, rising 1.06% per year among those who were underweight, 1.28% among those who were normal weight, 1.41% among those who were overweight, and 1.54% among those who were obese. These differences did not reach statistical significance, "but it’s thought that with higher numbers [of participants], these differences would reach statistical significance," Dr. Robertson said.

An association between the development of new trunk varicose veins and pregnancy was also observed. For example, the annual incidence of new trunk varicose veins was 1.24% among women who had never been pregnant, compared with 2.04% among women who had been pregnant at least four times. This finding was "borderline statistically significant," she said. "But with higher numbers of participants in each group, it’s thought that this would reach statistical significance."

The annual incidence of new varicose veins among participants who reported having a family history of varicose veins (defined as having a mother or father with the condition) was significantly higher compared with those who reported no family history of the condition (1.74% vs. 1.14%, respectively).

There was no significant difference in the annual incidence of new trunk varicose veins among those who reported a history of smoking at baseline compared with those who said that they never smoked (1.32% vs. 1.40%, respectively).

The cumulative incidence of new trunk varicose veins at follow-up was 13% among those who had no reflux at baseline, 23% among those who had deep reflux at baseline, 35% among those who had superficial reflux at baseline, and 42% among those who had deep and superficial reflux at baseline.

The study was funded by Scotland’s Chief Scientist Office. Dr. Robertson said that she had no relevant financial disclosures to make.

SAN DIEGO – The annual incidence of new trunk varicose veins in adults during 13 years of follow-up is 1.36% results from a large study showed.

There were no differences in the annual incidence rate between men and women, but the risk of developing new trunk varicose veins increased significantly with age. The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, but did not reach significance, perhaps because of the size of the study.

Those are key findings from the Edinburgh Vein Study, one of the first efforts to longitudinally measure the adult incidence of trunk varicose veins and to examine factors which increase the risk of varicose veins.

"There have been several studies conducted throughout the world, which have looked into the prevalence of varicose veins and associated risk factors, but few have examined new disease," Dr. Lindsay A. Robertson said at the annual meeting of the American Venous Forum. "While it is important to know about the prevalence of varicose veins, the design of studies is such that we cannot differentiate between the cause and effect. Therefore, it is important to start with people free of venous disease, [and] look at the risk factors, and then we can determine the true effect of such risk factors on the development of venous disease."

The Edinburgh Vein Study was a population cohort study conducted from 1994 to 1996 in a random sample of 1,566 citizens of Edinburgh, who were between the ages of 18 and 64 years. Dr. Robertson of the University of Edinburgh and her associates invited survivors of that cohort to participate in a 13-year follow-up examination, which included clinical classification of venous disease using CEAP, a duplex scan of leg veins, and measurements of height and weight, as well as a questionnaire for lifestyle risk factors such as mobility at work, smoking, pregnancy, previous treatment for varicose veins, and family history.

From baseline there were 1,446 survivors. Of those, 880 took part in the follow-up study, for a response rate of 60.4%. Of these, 490 were women and 390 were men. Their mean age was 60 years.

Dr. Robertson presented findings from 555 of the 880 participants who had no trunk varicose veins at baseline. Of these 555 participants, 101 developed grade C2 trunk varicose veins in any leg during the 13-year follow-up, for an overall incidence rate of 18.2% and an annual incidence rate of 1.36%. The annual incidence in men and women was similar (1.31% and 1.39%, respectively).

The annual incidence of new trunk varicose veins rose significantly with age, rising 0.73% per year among those aged 18-34 years, 1.23% among those aged 35-44 years, 1.62% among those aged 45-54 years, and 1.93% among those aged 55-64 years.

The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, rising 1.06% per year among those who were underweight, 1.28% among those who were normal weight, 1.41% among those who were overweight, and 1.54% among those who were obese. These differences did not reach statistical significance, "but it’s thought that with higher numbers [of participants], these differences would reach statistical significance," Dr. Robertson said.

An association between the development of new trunk varicose veins and pregnancy was also observed. For example, the annual incidence of new trunk varicose veins was 1.24% among women who had never been pregnant, compared with 2.04% among women who had been pregnant at least four times. This finding was "borderline statistically significant," she said. "But with higher numbers of participants in each group, it’s thought that this would reach statistical significance."

The annual incidence of new varicose veins among participants who reported having a family history of varicose veins (defined as having a mother or father with the condition) was significantly higher compared with those who reported no family history of the condition (1.74% vs. 1.14%, respectively).

There was no significant difference in the annual incidence of new trunk varicose veins among those who reported a history of smoking at baseline compared with those who said that they never smoked (1.32% vs. 1.40%, respectively).

The cumulative incidence of new trunk varicose veins at follow-up was 13% among those who had no reflux at baseline, 23% among those who had deep reflux at baseline, 35% among those who had superficial reflux at baseline, and 42% among those who had deep and superficial reflux at baseline.

The study was funded by Scotland’s Chief Scientist Office. Dr. Robertson said that she had no relevant financial disclosures to make.

SAN DIEGO – The annual incidence of new trunk varicose veins in adults during 13 years of follow-up is 1.36% results from a large study showed.

There were no differences in the annual incidence rate between men and women, but the risk of developing new trunk varicose veins increased significantly with age. The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, but did not reach significance, perhaps because of the size of the study.

Those are key findings from the Edinburgh Vein Study, one of the first efforts to longitudinally measure the adult incidence of trunk varicose veins and to examine factors which increase the risk of varicose veins.

"There have been several studies conducted throughout the world, which have looked into the prevalence of varicose veins and associated risk factors, but few have examined new disease," Dr. Lindsay A. Robertson said at the annual meeting of the American Venous Forum. "While it is important to know about the prevalence of varicose veins, the design of studies is such that we cannot differentiate between the cause and effect. Therefore, it is important to start with people free of venous disease, [and] look at the risk factors, and then we can determine the true effect of such risk factors on the development of venous disease."

The Edinburgh Vein Study was a population cohort study conducted from 1994 to 1996 in a random sample of 1,566 citizens of Edinburgh, who were between the ages of 18 and 64 years. Dr. Robertson of the University of Edinburgh and her associates invited survivors of that cohort to participate in a 13-year follow-up examination, which included clinical classification of venous disease using CEAP, a duplex scan of leg veins, and measurements of height and weight, as well as a questionnaire for lifestyle risk factors such as mobility at work, smoking, pregnancy, previous treatment for varicose veins, and family history.

From baseline there were 1,446 survivors. Of those, 880 took part in the follow-up study, for a response rate of 60.4%. Of these, 490 were women and 390 were men. Their mean age was 60 years.

Dr. Robertson presented findings from 555 of the 880 participants who had no trunk varicose veins at baseline. Of these 555 participants, 101 developed grade C2 trunk varicose veins in any leg during the 13-year follow-up, for an overall incidence rate of 18.2% and an annual incidence rate of 1.36%. The annual incidence in men and women was similar (1.31% and 1.39%, respectively).

The annual incidence of new trunk varicose veins rose significantly with age, rising 0.73% per year among those aged 18-34 years, 1.23% among those aged 35-44 years, 1.62% among those aged 45-54 years, and 1.93% among those aged 55-64 years.

The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, rising 1.06% per year among those who were underweight, 1.28% among those who were normal weight, 1.41% among those who were overweight, and 1.54% among those who were obese. These differences did not reach statistical significance, "but it’s thought that with higher numbers [of participants], these differences would reach statistical significance," Dr. Robertson said.

An association between the development of new trunk varicose veins and pregnancy was also observed. For example, the annual incidence of new trunk varicose veins was 1.24% among women who had never been pregnant, compared with 2.04% among women who had been pregnant at least four times. This finding was "borderline statistically significant," she said. "But with higher numbers of participants in each group, it’s thought that this would reach statistical significance."

The annual incidence of new varicose veins among participants who reported having a family history of varicose veins (defined as having a mother or father with the condition) was significantly higher compared with those who reported no family history of the condition (1.74% vs. 1.14%, respectively).

There was no significant difference in the annual incidence of new trunk varicose veins among those who reported a history of smoking at baseline compared with those who said that they never smoked (1.32% vs. 1.40%, respectively).

The cumulative incidence of new trunk varicose veins at follow-up was 13% among those who had no reflux at baseline, 23% among those who had deep reflux at baseline, 35% among those who had superficial reflux at baseline, and 42% among those who had deep and superficial reflux at baseline.

The study was funded by Scotland’s Chief Scientist Office. Dr. Robertson said that she had no relevant financial disclosures to make.

SAN DIEGO – The annual incidence of new trunk varicose veins in adults during 13 years of follow-up is 1.36% results from a large study showed.

There were no differences in the annual incidence rate between men and women, but the risk of developing new trunk varicose veins increased significantly with age. The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, but did not reach significance, perhaps because of the size of the study.

Those are key findings from the Edinburgh Vein Study, one of the first efforts to longitudinally measure the adult incidence of trunk varicose veins and to examine factors which increase the risk of varicose veins.

"There have been several studies conducted throughout the world, which have looked into the prevalence of varicose veins and associated risk factors, but few have examined new disease," Dr. Lindsay A. Robertson said at the annual meeting of the American Venous Forum. "While it is important to know about the prevalence of varicose veins, the design of studies is such that we cannot differentiate between the cause and effect. Therefore, it is important to start with people free of venous disease, [and] look at the risk factors, and then we can determine the true effect of such risk factors on the development of venous disease."

The Edinburgh Vein Study was a population cohort study conducted from 1994 to 1996 in a random sample of 1,566 citizens of Edinburgh, who were between the ages of 18 and 64 years. Dr. Robertson of the University of Edinburgh and her associates invited survivors of that cohort to participate in a 13-year follow-up examination, which included clinical classification of venous disease using CEAP, a duplex scan of leg veins, and measurements of height and weight, as well as a questionnaire for lifestyle risk factors such as mobility at work, smoking, pregnancy, previous treatment for varicose veins, and family history.

From baseline there were 1,446 survivors. Of those, 880 took part in the follow-up study, for a response rate of 60.4%. Of these, 490 were women and 390 were men. Their mean age was 60 years.

Dr. Robertson presented findings from 555 of the 880 participants who had no trunk varicose veins at baseline. Of these 555 participants, 101 developed grade C2 trunk varicose veins in any leg during the 13-year follow-up, for an overall incidence rate of 18.2% and an annual incidence rate of 1.36%. The annual incidence in men and women was similar (1.31% and 1.39%, respectively).

The annual incidence of new trunk varicose veins rose significantly with age, rising 0.73% per year among those aged 18-34 years, 1.23% among those aged 35-44 years, 1.62% among those aged 45-54 years, and 1.93% among those aged 55-64 years.

The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, rising 1.06% per year among those who were underweight, 1.28% among those who were normal weight, 1.41% among those who were overweight, and 1.54% among those who were obese. These differences did not reach statistical significance, "but it’s thought that with higher numbers [of participants], these differences would reach statistical significance," Dr. Robertson said.

An association between the development of new trunk varicose veins and pregnancy was also observed. For example, the annual incidence of new trunk varicose veins was 1.24% among women who had never been pregnant, compared with 2.04% among women who had been pregnant at least four times. This finding was "borderline statistically significant," she said. "But with higher numbers of participants in each group, it’s thought that this would reach statistical significance."

The annual incidence of new varicose veins among participants who reported having a family history of varicose veins (defined as having a mother or father with the condition) was significantly higher compared with those who reported no family history of the condition (1.74% vs. 1.14%, respectively).

There was no significant difference in the annual incidence of new trunk varicose veins among those who reported a history of smoking at baseline compared with those who said that they never smoked (1.32% vs. 1.40%, respectively).

The cumulative incidence of new trunk varicose veins at follow-up was 13% among those who had no reflux at baseline, 23% among those who had deep reflux at baseline, 35% among those who had superficial reflux at baseline, and 42% among those who had deep and superficial reflux at baseline.

The study was funded by Scotland’s Chief Scientist Office. Dr. Robertson said that she had no relevant financial disclosures to make.

SAN DIEGO – The annual incidence of new trunk varicose veins in adults during 13 years of follow-up is 1.36% results from a large study showed.

There were no differences in the annual incidence rate between men and women, but the risk of developing new trunk varicose veins increased significantly with age. The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, but did not reach significance, perhaps because of the size of the study.

Those are key findings from the Edinburgh Vein Study, one of the first efforts to longitudinally measure the adult incidence of trunk varicose veins and to examine factors which increase the risk of varicose veins.

"There have been several studies conducted throughout the world, which have looked into the prevalence of varicose veins and associated risk factors, but few have examined new disease," Dr. Lindsay A. Robertson said at the annual meeting of the American Venous Forum. "While it is important to know about the prevalence of varicose veins, the design of studies is such that we cannot differentiate between the cause and effect. Therefore, it is important to start with people free of venous disease, [and] look at the risk factors, and then we can determine the true effect of such risk factors on the development of venous disease."

The Edinburgh Vein Study was a population cohort study conducted from 1994 to 1996 in a random sample of 1,566 citizens of Edinburgh, who were between the ages of 18 and 64 years. Dr. Robertson of the University of Edinburgh and her associates invited survivors of that cohort to participate in a 13-year follow-up examination, which included clinical classification of venous disease using CEAP, a duplex scan of leg veins, and measurements of height and weight, as well as a questionnaire for lifestyle risk factors such as mobility at work, smoking, pregnancy, previous treatment for varicose veins, and family history.

From baseline there were 1,446 survivors. Of those, 880 took part in the follow-up study, for a response rate of 60.4%. Of these, 490 were women and 390 were men. Their mean age was 60 years.

Dr. Robertson presented findings from 555 of the 880 participants who had no trunk varicose veins at baseline. Of these 555 participants, 101 developed grade C2 trunk varicose veins in any leg during the 13-year follow-up, for an overall incidence rate of 18.2% and an annual incidence rate of 1.36%. The annual incidence in men and women was similar (1.31% and 1.39%, respectively).

The annual incidence of new trunk varicose veins rose significantly with age, rising 0.73% per year among those aged 18-34 years, 1.23% among those aged 35-44 years, 1.62% among those aged 45-54 years, and 1.93% among those aged 55-64 years.

The annual incidence of new trunk varicose veins also rose steadily with increasing BMI, rising 1.06% per year among those who were underweight, 1.28% among those who were normal weight, 1.41% among those who were overweight, and 1.54% among those who were obese. These differences did not reach statistical significance, "but it’s thought that with higher numbers [of participants], these differences would reach statistical significance," Dr. Robertson said.

An association between the development of new trunk varicose veins and pregnancy was also observed. For example, the annual incidence of new trunk varicose veins was 1.24% among women who had never been pregnant, compared with 2.04% among women who had been pregnant at least four times. This finding was "borderline statistically significant," she said. "But with higher numbers of participants in each group, it’s thought that this would reach statistical significance."

The annual incidence of new varicose veins among participants who reported having a family history of varicose veins (defined as having a mother or father with the condition) was significantly higher compared with those who reported no family history of the condition (1.74% vs. 1.14%, respectively).

There was no significant difference in the annual incidence of new trunk varicose veins among those who reported a history of smoking at baseline compared with those who said that they never smoked (1.32% vs. 1.40%, respectively).

The cumulative incidence of new trunk varicose veins at follow-up was 13% among those who had no reflux at baseline, 23% among those who had deep reflux at baseline, 35% among those who had superficial reflux at baseline, and 42% among those who had deep and superficial reflux at baseline.

The study was funded by Scotland’s Chief Scientist Office. Dr. Robertson said that she had no relevant financial disclosures to make.

Major Finding: Short-interval mammograms yielded 2.9 new ipsilateral invasive breast cancers per 1,000 patients, which was significantly lower than the 4.4 cancers per 1,000 patients from annual screening mammograms over the same time frame and study population.

Data Source: An analysis of 1,386 patients who had a lumpectomy and underwent short-interval mammography at Intermountain Healthcare in Utah in 2003-2007.

Disclosures: Dr. Sause said that he had no relevant financial disclosures.

SAN DIEGO – Short-interval mammography following breast-conserving therapy is not more effective than annual screening mammography in detecting new ipsilateral invasive breast cancer, results from a large health care system study demonstrated.

The National Comprehensive Cancer Network recommends a mammogram 6-12 months following radiation, whereas the American Society of Clinical Oncology recommends the first posttreatment mammogram 1 year after diagnosis, but no earlier than 6 months after completion of radiotherapy, Dr. William T. Sause said at the meeting.

For the past 10 years Dr. Sause and his associates at Intermountain Healthcare, an organization of 24 hospitals in Utah, have conducted posttreatment mammograms at 6-month intervals for the first 2 years after patients have completed radiotherapy, followed by annual screening. The researchers use mammography tracking software that has been implemented and standardized at all facilities.

To evaluate the effectiveness of this approach, Dr. Sause and his associates reviewed the records of 1,454 patients who had a lumpectomy and radiation between 2003 and 2007. Of those, 1,386 underwent short-interval mammography.

All recurrences were reviewed by a dedicated breast radiologist to verify the recurrence, type, and diagnosis.

Dr. Sause reported that 25 patients (1.8%) experienced a recurrence during the study period. Most recurrences (84%) manifested within 24 months, “which is not surprising, because our study closed in 2007, so the follow-up isn't much longer than that,” he said.

Nearly half of the recurrences (44%) were ductal in situ carcinoma, and 52% occurred in the ipsilateral breast. Of the ipsilateral breast recurrences, 62% were ductal in situ carcinoma.

No ipsilateral or invasive recurrences were identified within 12 months. Five (20%) ipsilateral and invasive recurrences were identified at 12-24 months, for a relative risk of 0.4%. The researchers found that the screening efficacy for patients undergoing short-term mammography is significantly lower compared with that of the general screening population (a yield of 2.9 vs. 4.4 cancers per 1,000 patients, respectively).

“Short-term mammography following modern breast conservation has very low yield for new ipsilateral invasive breast cancer,” Dr. Sause concluded. “Eliminating short-term mammography would result in a minimum direct cost savings of approximately $1,160,000 for this patient cohort over the study period.”

He said that the analysis “represents a worthwhile demonstration of comparative effectiveness research and has potential to be expanded to other treatment areas.”

Electronic data resources, clinical leadership, data and statistical support, and cultural reorganization of priorities are needed for effective comparative effectiveness research, he continued. “All of these are challenging,” he acknowledged. “There are misaligned incentives between health care providers and payers. It's very easy for me to challenge the utilization of mammography. It's not so easy to challenge the utilization of IMRT [intensity-modulated radiation therapy].

Major Finding: Short-interval mammograms yielded 2.9 new ipsilateral invasive breast cancers per 1,000 patients, which was significantly lower than the 4.4 cancers per 1,000 patients from annual screening mammograms over the same time frame and study population.

Data Source: An analysis of 1,386 patients who had a lumpectomy and underwent short-interval mammography at Intermountain Healthcare in Utah in 2003-2007.

Disclosures: Dr. Sause said that he had no relevant financial disclosures.

SAN DIEGO – Short-interval mammography following breast-conserving therapy is not more effective than annual screening mammography in detecting new ipsilateral invasive breast cancer, results from a large health care system study demonstrated.

The National Comprehensive Cancer Network recommends a mammogram 6-12 months following radiation, whereas the American Society of Clinical Oncology recommends the first posttreatment mammogram 1 year after diagnosis, but no earlier than 6 months after completion of radiotherapy, Dr. William T. Sause said at the meeting.

For the past 10 years Dr. Sause and his associates at Intermountain Healthcare, an organization of 24 hospitals in Utah, have conducted posttreatment mammograms at 6-month intervals for the first 2 years after patients have completed radiotherapy, followed by annual screening. The researchers use mammography tracking software that has been implemented and standardized at all facilities.

To evaluate the effectiveness of this approach, Dr. Sause and his associates reviewed the records of 1,454 patients who had a lumpectomy and radiation between 2003 and 2007. Of those, 1,386 underwent short-interval mammography.

All recurrences were reviewed by a dedicated breast radiologist to verify the recurrence, type, and diagnosis.

Dr. Sause reported that 25 patients (1.8%) experienced a recurrence during the study period. Most recurrences (84%) manifested within 24 months, “which is not surprising, because our study closed in 2007, so the follow-up isn't much longer than that,” he said.

Nearly half of the recurrences (44%) were ductal in situ carcinoma, and 52% occurred in the ipsilateral breast. Of the ipsilateral breast recurrences, 62% were ductal in situ carcinoma.

No ipsilateral or invasive recurrences were identified within 12 months. Five (20%) ipsilateral and invasive recurrences were identified at 12-24 months, for a relative risk of 0.4%. The researchers found that the screening efficacy for patients undergoing short-term mammography is significantly lower compared with that of the general screening population (a yield of 2.9 vs. 4.4 cancers per 1,000 patients, respectively).

“Short-term mammography following modern breast conservation has very low yield for new ipsilateral invasive breast cancer,” Dr. Sause concluded. “Eliminating short-term mammography would result in a minimum direct cost savings of approximately $1,160,000 for this patient cohort over the study period.”

He said that the analysis “represents a worthwhile demonstration of comparative effectiveness research and has potential to be expanded to other treatment areas.”

Electronic data resources, clinical leadership, data and statistical support, and cultural reorganization of priorities are needed for effective comparative effectiveness research, he continued. “All of these are challenging,” he acknowledged. “There are misaligned incentives between health care providers and payers. It's very easy for me to challenge the utilization of mammography. It's not so easy to challenge the utilization of IMRT [intensity-modulated radiation therapy].

Major Finding: Short-interval mammograms yielded 2.9 new ipsilateral invasive breast cancers per 1,000 patients, which was significantly lower than the 4.4 cancers per 1,000 patients from annual screening mammograms over the same time frame and study population.

Data Source: An analysis of 1,386 patients who had a lumpectomy and underwent short-interval mammography at Intermountain Healthcare in Utah in 2003-2007.

Disclosures: Dr. Sause said that he had no relevant financial disclosures.

SAN DIEGO – Short-interval mammography following breast-conserving therapy is not more effective than annual screening mammography in detecting new ipsilateral invasive breast cancer, results from a large health care system study demonstrated.

The National Comprehensive Cancer Network recommends a mammogram 6-12 months following radiation, whereas the American Society of Clinical Oncology recommends the first posttreatment mammogram 1 year after diagnosis, but no earlier than 6 months after completion of radiotherapy, Dr. William T. Sause said at the meeting.

For the past 10 years Dr. Sause and his associates at Intermountain Healthcare, an organization of 24 hospitals in Utah, have conducted posttreatment mammograms at 6-month intervals for the first 2 years after patients have completed radiotherapy, followed by annual screening. The researchers use mammography tracking software that has been implemented and standardized at all facilities.

To evaluate the effectiveness of this approach, Dr. Sause and his associates reviewed the records of 1,454 patients who had a lumpectomy and radiation between 2003 and 2007. Of those, 1,386 underwent short-interval mammography.

All recurrences were reviewed by a dedicated breast radiologist to verify the recurrence, type, and diagnosis.

Dr. Sause reported that 25 patients (1.8%) experienced a recurrence during the study period. Most recurrences (84%) manifested within 24 months, “which is not surprising, because our study closed in 2007, so the follow-up isn't much longer than that,” he said.

Nearly half of the recurrences (44%) were ductal in situ carcinoma, and 52% occurred in the ipsilateral breast. Of the ipsilateral breast recurrences, 62% were ductal in situ carcinoma.

No ipsilateral or invasive recurrences were identified within 12 months. Five (20%) ipsilateral and invasive recurrences were identified at 12-24 months, for a relative risk of 0.4%. The researchers found that the screening efficacy for patients undergoing short-term mammography is significantly lower compared with that of the general screening population (a yield of 2.9 vs. 4.4 cancers per 1,000 patients, respectively).

“Short-term mammography following modern breast conservation has very low yield for new ipsilateral invasive breast cancer,” Dr. Sause concluded. “Eliminating short-term mammography would result in a minimum direct cost savings of approximately $1,160,000 for this patient cohort over the study period.”

He said that the analysis “represents a worthwhile demonstration of comparative effectiveness research and has potential to be expanded to other treatment areas.”

Electronic data resources, clinical leadership, data and statistical support, and cultural reorganization of priorities are needed for effective comparative effectiveness research, he continued. “All of these are challenging,” he acknowledged. “There are misaligned incentives between health care providers and payers. It's very easy for me to challenge the utilization of mammography. It's not so easy to challenge the utilization of IMRT [intensity-modulated radiation therapy].

SAN FRANCISCO – Lung function alone is a poor marker of asthma control in children, results from a large retrospective analysis demonstrated.

“Physicians should use all components of the 2007 National Asthma Education and Prevention Program Expert Report 3 guidelines, asking questions to patients not only about daytime and nighttime symptoms, but doing lung function testing as well,” Dr. Edward K. Hu advised during a poster session at the meeting.

“Even [among] those patients who are enrolled in a disease management program, there is still going to be a large minority who are going to be uncontrolled in one way or another, despite follow-up visits and seeing asthma specialists,” the allergist advised.

Dr. Hu, a fellow in the division of allergy and immunology at the Los Angeles County/University of Southern California Medical Center, Los Angeles, and his associates studied 453 children aged 5–18 years who were enrolled in an asthma management program in Los Angeles County in 2009 and who made a total of 886 follow-up visits.

Initial analysis defined asthma control based solely on lung function.

Secondary analysis included all components of asthma control based on the 2007 National Asthma Education and Prevention Program Expert Report 3, which included impairment and risk.

Of the 453 children, 61% were male and 83% were Hispanic.

At baseline more than one-quarter of pediatric patients (29%) had intermittent disease, 21% had mild persistent disease, 25% had moderate persistent disease, and 25% had severe persistent disease.

Dr. Hu reported that when lung function alone was used, 17% of children exhibited asthma that was not well controlled, and 5% exhibited asthma that was poorly controlled.

Inclusion of impairment and risk resulted in a downgrade of asthma control in an additional 22% of children, he reported.

The researchers at the Los Angeles County/USC Medical Center also found that males, aged 8–11 years, were significantly more likely than their female counterparts to present with normal lung function and uncontrolled disease due to other factors (24% vs. 15%).

Dr. Hu said that he had no relevant financial disclosures.

SAN FRANCISCO – Lung function alone is a poor marker of asthma control in children, results from a large retrospective analysis demonstrated.

“Physicians should use all components of the 2007 National Asthma Education and Prevention Program Expert Report 3 guidelines, asking questions to patients not only about daytime and nighttime symptoms, but doing lung function testing as well,” Dr. Edward K. Hu advised during a poster session at the meeting.

“Even [among] those patients who are enrolled in a disease management program, there is still going to be a large minority who are going to be uncontrolled in one way or another, despite follow-up visits and seeing asthma specialists,” the allergist advised.

Dr. Hu, a fellow in the division of allergy and immunology at the Los Angeles County/University of Southern California Medical Center, Los Angeles, and his associates studied 453 children aged 5–18 years who were enrolled in an asthma management program in Los Angeles County in 2009 and who made a total of 886 follow-up visits.

Initial analysis defined asthma control based solely on lung function.

Secondary analysis included all components of asthma control based on the 2007 National Asthma Education and Prevention Program Expert Report 3, which included impairment and risk.

Of the 453 children, 61% were male and 83% were Hispanic.

At baseline more than one-quarter of pediatric patients (29%) had intermittent disease, 21% had mild persistent disease, 25% had moderate persistent disease, and 25% had severe persistent disease.

Dr. Hu reported that when lung function alone was used, 17% of children exhibited asthma that was not well controlled, and 5% exhibited asthma that was poorly controlled.

Inclusion of impairment and risk resulted in a downgrade of asthma control in an additional 22% of children, he reported.

The researchers at the Los Angeles County/USC Medical Center also found that males, aged 8–11 years, were significantly more likely than their female counterparts to present with normal lung function and uncontrolled disease due to other factors (24% vs. 15%).

Dr. Hu said that he had no relevant financial disclosures.

SAN FRANCISCO – Lung function alone is a poor marker of asthma control in children, results from a large retrospective analysis demonstrated.

“Physicians should use all components of the 2007 National Asthma Education and Prevention Program Expert Report 3 guidelines, asking questions to patients not only about daytime and nighttime symptoms, but doing lung function testing as well,” Dr. Edward K. Hu advised during a poster session at the meeting.

“Even [among] those patients who are enrolled in a disease management program, there is still going to be a large minority who are going to be uncontrolled in one way or another, despite follow-up visits and seeing asthma specialists,” the allergist advised.

Dr. Hu, a fellow in the division of allergy and immunology at the Los Angeles County/University of Southern California Medical Center, Los Angeles, and his associates studied 453 children aged 5–18 years who were enrolled in an asthma management program in Los Angeles County in 2009 and who made a total of 886 follow-up visits.

Initial analysis defined asthma control based solely on lung function.

Secondary analysis included all components of asthma control based on the 2007 National Asthma Education and Prevention Program Expert Report 3, which included impairment and risk.

Of the 453 children, 61% were male and 83% were Hispanic.

At baseline more than one-quarter of pediatric patients (29%) had intermittent disease, 21% had mild persistent disease, 25% had moderate persistent disease, and 25% had severe persistent disease.

Dr. Hu reported that when lung function alone was used, 17% of children exhibited asthma that was not well controlled, and 5% exhibited asthma that was poorly controlled.

Inclusion of impairment and risk resulted in a downgrade of asthma control in an additional 22% of children, he reported.

The researchers at the Los Angeles County/USC Medical Center also found that males, aged 8–11 years, were significantly more likely than their female counterparts to present with normal lung function and uncontrolled disease due to other factors (24% vs. 15%).

Dr. Hu said that he had no relevant financial disclosures.