tbuckley/cabot-search huggingface dataset:
NCCN NewsNCCN Publishes First-Ever US Guidelines for Rare Cancers Associated With Pregnancy<i>JNCCN</i>Strengthens Editorial Focus on Original, Impactful Research into Cancer Care DeliveryCongressional CAR T 101
Authors: John Lurain, Robert Lurie, R Reynolds, Margaret Tempero
Journal: Journal of the National Comprehensive Cancer Network (2018)

The NCCN has released new treatment guidelines for a group of rare cancers that impact women during pregnancy.Gestational trophoblastic neoplasia (GTN), also known as gestational trophoblastic disease (GTD), can occur when tumors develop in the cells that would normally form the placenta during pregnancy.This happens in approximately 1 out of every 1,000 US pregnancies, although it is more common in many Asian and African countries.Due to the rare nature of this condition, and the small number of specialists worldwide, providers are often not aware of how to provide the best care for people with GTN."These guidelines are sorely needed," explained David Mutch, MD, Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, who leads the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) committee for GTN."By compiling expert consensus, we can standardize the way this uncommon disease is treated.When treated properly, GTN can almost always be cured, but deviating from that standard can have severe consequences.Plus, by providing clear instructions for how best to treat GTN, we can streamline the insurance approval process for more efficient care."The NCCN Guidelines for GTN detail treatments for several variations of the disease.For molar pregnancy (also known as a hydatiform mole; a rare mass that can form inside the womb during early pregnancy, resulting in an abnormal fetus), surgery is the first, and often only, treatment required.It is generally performed via suction dilation and curettage.Low-risk GTN is primarily treated with single-agent chemotherapy, although additional chemotherapy or surgery may be required for persistent disease.With highrisk GTN, treatment typically involves multi-agent chemotherapy, with possible radiation therapy for brain metastasis.Surgery can be used for chemotherapy-resistant disease.
Malignant Potential of Benign Breast Lesions: Implications for Estrogen Therapy
Journal: JAMA (1991)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
MINERS' NYSTAGMUS
Journal: JAMA (1924)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Vietnam and birth defects
Authors: B. B. Dan
Journal: JAMA (1984)

Between 1962 and 1971, US military forces sprayed herbicides over 3.5 million acres of jungle in Vietnam.<sup>1</sup>The herbicides were identified by the color bandings on their containers (green, orange, purple, white, pink, and blue). They were used for defoliation, crop destruction, and to clear vegetation around military installations. The designation "Operation Ranch Hand" was used for the aerial dispersal of these herbicides from fixed-wing aircraft. Small quantities also were sprayed from helicopters and riverboats and by hand-held applicators. Agent Orange was the most widely used of these herbicides; more than 100 million pounds of the substance was sprayed in Vietnam during a ten-year period.<sup>1</sup> Agent Orange is a 50:50 mixture of the butyl esters of 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T). Both 2,4-D and 2,4,5-T have been used extensively in the United States for more than 30 years as agricultural herbicides in the control of broadleaf
Anti-epidermal growth factor (EGFR) antibody cetuximab in patients with stage IV colorectal carcinoma who failed all standard therapy: An Access Protocol
Authors: L. Zehngebot, I. Zackon, C. A. Henderson, G. Spitzer, P. J. Stella, M. Levine, L. S. Rosen
Journal: Journal of Clinical Oncology (2004)

3753 Background: Cetuximab (Erbitux), an IgG1 monoclonal antibody, has shown activity against colorectal carcinoma (CRC), both as a single agent (ASCO 2002: A504) and in combination therapy (ASCO 2001: A7; ASCO 2003: A1012). Methods: This is an ongoing study to evaluate the safety of cetuximab in patients (pts) with metastatic CRC via an access program. Eligible pts have exhausted all standard therapies, having received at least two chemotherapy regimens for metastatic disease or adjuvant therapy plus one chemotherapy regimen for metastatic disease if the patient progressed within 6 months of completing adjuvant therapy. Prior chemotherapy must have included irinotecan, oxaliplatin and a fluoropyrimidine. Tumors must be EGFR+. Pts receive intravenous cetuximab therapy as 400 mg/m2 over 120 minutes (week 1 only) followed by 250 mg/m2 weekly over 60 minutes. Therapy continues until clinical evidence of disease progression. Results: As of December 15, 2003, 510 pts were enrolled with 331 in active treatment. Preliminary demographic data are available for the first 115 pts: M/F 61/54, mean age 60 years (range 31–81) and a mean duration of therapy 8 weeks (range 1–25). Reasons for discontinuation are available for 72 pts: progressive disease (51); toxicity (7), death (7), clinical deterioration (4), subject request (2), and other (1). Severe adverse event data is available on all 510 pts. Investigator-reported definitely and likely related grade 3/4 events include 14 hypersensitivity reactions. Grade 3/4 events deemed possibly related include headache, syncope, hypotension, diarrhea, asthenia, vomiting, abdominal pain, nausea, ventricular dysfunction, dehydration, dyskinesia and hypertension (1 pt each). Conclusions: Preliminary safety data from this access protocol demonstrate no unexpected toxicities. Single agent cetuximab is a viable option for colorectal cancer patients who have exhausted all standard therapies. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Bristol-Myers Squibb; Imclone Systems Imclone Systems Bristol-Myers Squibb Bristol-Myers Squibb, ImClone Systems Incorporated Bristol-Myers Squibb Bristol-Myers Squibb
Medicine and nursing in the 1970's. A position statement
Journal: JAMA (1970)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Endoscopic submucosal dissection using a novel irrigation wiper-knife
Authors: K Kume, M Yamasaki, K Kanda, I Yoshikawa, M Otsuki
Journal: Endoscopy (2007)

Endoscopic submucosal dissection techniques require special skills and the procedure can be very prolonged [1] [2]. In response these drawbacks, we have designed a new dissection knife, the “wiper-knife”, which simplifies the procedure.
Adult supraglottitis. A prospective analysis
Authors: J Shapiro, R D Eavey, A S Baker
Journal: JAMA (1988)

Epiglottitis in pediatric patients is an infection caused by Haemophilus influenzae type b, which can lead rapidly to sepsis and an asphyxial death. In an effort to study the cause and clinical course of adult epiglottitis, eight serially hospitalized adult patients with supraglottitis over a ten-month period were prospectively evaluated, including a daily laryngeal examination. Although multiple anatomic sites in the larynx and oropharynx were inflamed, the epiglottis was often not the most involved area and was actually normal in one patient. Bacterial cultures were harvested from blood, the nasopharynx, the oropharynx, and the vallecula in all patients and the preepiglottic space in two patients. In no case was H influenzae demonstrated. No patient developed respiratory compromise. It was concluded that epiglottitis is an inaccurate description of this disorder and that this non-H influenzae adult variety of supraglottitis seemingly can follow a less pernicious course than the classically described infection.
Tafamidis (Vyndaqel; Vyndamax) for Transthyretin Amyloid Cardiomyopathy
Journal: JAMA (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
The future of the VA. Centralization, costs, politics, and presentism
Authors: J. A. Pittman
Journal: JAMA (1995)

To the veterans of the armed forces of this country, we owe the very existence of the United States as a nation, independent of domination by governments of Germany, Japan, the Soviet Union, or others external to ours. It is impossible today to recapture the feeling of gratitude that pervaded this country immediately after most wars, especially World War II. In that atmosphere, President Truman signed Public Law 293 on January 3, 1946, less than 6 months after the war's end—"an act to establish a Department of Medicine and Surgery in the Veterans Administration."<sup>1,2</sup>The VA had existed long before 1946. The history of special care for veterans reaches far back into the mists of ancient times, but Adkins traces care given veterans by the American government to 1593, when the British Parliament passed an "Acte for the Relief of Souldiours" for those who had defended against the Spanish
Update: Mass Vaccination With Oral Poliovirus Vaccine—Asia and Europe, 1996
Journal: JAMA (1996)

In 1995, a group of 18 geographically contiguous countries in Europe, Central and South Asia, and the Middle East cooperated in conducting coordinated National Immunization Days (NIDs) with oral poliovirus vaccine (OPV). The World Health Organization (WHO) had designated this effort "Operation MECACAR" (MEditerranean, CAucasus, and Central Asian Republics). Operation MECACAR was repeated in 1996 with the addition of the Russian Federation. This report describes OPV coverage achieved during the mass vaccination campaign in 1996 and summarizes the impact of the NIDs on poliomyelitis incidence during 1995, and the first 6 months of 1996.
Smoking Cessation
Authors: Erin Brender, Cassio Lynm, Richard M. Glass
Journal: JAMA (2010)

is a public service of JAMA.The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis.For specific information concerning your personal medical condition, JAMA suggests that you consult your physician.This page may be photocopied noncommercially by physicians and other health care professionals to share with patients.To purchase bulk reprints, call 312/464-0776.
<i>Degeneration and Regeneration of the Nervous System.</i>By S. Ramon Y Cajal, M. D., F. R. S., Director of the Instituto Cajal, Madrid. Honorary Professor of Pathology in the University of Madrid. Translated and edited by Raoul M. May, Ph. D. (Harv.) D. ès Sc. (Paris). Laboratoires d'Anatomie et Histologie Comparées et de Chimie Biologique, Faculté des Sciences, Paris. (<i>New York: Oxford University Press, American Branch, 1928, Vol. 1, pp. 396, and Vol. 2, pp. 369-769.</i>)
Authors: Leo M. Davidoff
Journal: American Journal of Psychiatry (1929)
Pediatrics for Nurses.
Journal: JAMA (1924)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
From the Food and Drug Administration
Authors: S L Nightingale
Journal: JAMA (1994)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Effects of Chlorprothixene in Patients with Paranoid Symptoms
Journal: JAMA (1963)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Introduction to the History of Science. Volume I from Homer to Omar Khayyam.
Journal: JAMA (1928)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
测量两种蛋白质, 帮助评估哪种黑色素瘤最有可能传播
Authors: R. Ellis, D. Tang, B. Nasr, A. Greenwood, A. McConnell, M.E. Anagnostou, M. Elias, S. Verykiou, D. Bajwa, T. Ewen, N.J. Reynolds, P. Barrett, E. Carling, G. Watson, J. Armstrong, A.J. Allen, S. Horswell, M. Labus, P.E. Lovat
Journal: British Journal of Dermatology (2020)

黑色素瘤是最致命的皮肤癌, 全球发病率同比增长。主要未满足的需求是发现用于识别面临疾病进展高风险的早期黑色素瘤患者的方法, 这意味着它将传播到身体其他部位。 这项英国研究旨在确定在重叠黑色素瘤的皮肤上(皮肤表皮上层)的两种蛋白质 AMBRA1 和兜甲蛋白的缺失是否能够预测哪些患者存在疾病传播的风险。 最初, 在 79 例患者的黑色素瘤活检中评估了 AMBRA1 水平。结果表明 AMBRA1 在重叠表皮中减少或缺失与疾病传播风险更高相关。 通过测量表皮兜甲蛋白和 AMBRA1 (eAMLo) 的合并水平, 预测黑色素瘤进展风险的能力得到改善。 通过研究另外 379 个具有至少 10 年随访数据的黑色素瘤样本(显示患者发生的事件),作者发现 eAMLo 缺失的 I 期(早期)黑色素瘤的传播可能性比维持 eAMLo 水平的黑色素瘤多近四倍。 重要的是, eAMLo 保留(即未缺失)的患者只有 1.7% 的疾病进展几率。黑色素瘤的厚度是其分期(进展)测量方法的一部分, 目前还向大于 1 mm 厚的黑色素瘤患者提供进一步的研究性检查, 称为前哨淋巴结活检 (SLNB)。 然而, 这种侵入性操作的阴性结果并未提供有关黑色素瘤传播几率的任何其他信息。重要的是, 在符合 SLNB 资格的黑色素瘤中评估 eAMLo 水平时, 结果进一步显示 eAMLo 与单独的 SLNB 相比可更好地识别面临真正低疾病传播风险的患者。 总体而言,这项研究表明, 测量 eAMLo 将有助于显示患者真正的黑色素瘤进展风险, 这将帮助指导他们的持续治疗和监测。 This summary relates to the study: 表皮自噬和 beclin 1 调控基因 1 与兜甲蛋白:癌症 I 期黑色素瘤预测和分层的典范转移。
Perioperative imaging strategies for carotid endarterectomy. An analysis of morbidity and cost-effectiveness in symptomatic patients
Authors: K. C. Kent
Journal: JAMA (1995)

<h3>Objective.</h3> —To assess the cost-effectiveness of four diagnostic strategies for the preoperative evaluation of symptomatic patients who are potential candidates for carotid endarterectomy (ie, 70% to 99% stenosis): (1) duplex sonography (DS), (2) magnetic resonance angiography (MRA), (3) contrast angiography (CA), and (4) the combination of DS and MRA supplemented by CA for disparate results. <h3>Methods.</h3> —Cost-effectiveness analysis based largely on published clinical trial data. Sensitivities and specificities of noninvasive tests were estimated from 81 patients undergoing prospective evaluation with DS, MRA, and CA. <h3>Outcome Measure.</h3> —Incremental cost per quality-adjusted year of life gained. <h3>Results.</h3> —For a hypothetical cohort of symptomatic patients undergoing evaluation for carotid endarterectomy, the combination of tests resulted in the greatest quality-adjusted life expectancy of the four options considered. After incorporating the costs of testing, surgery, and stroke, we found that neither the MRA nor the CA strategy was cost-effective. The combination of tests was more effective but more costly than DS, resulting in an additional cost of $22 400 per quality-adjusted year of life gained. For centers that do not have adequate MRA, CA resulted in an additional cost of $99 200 per quality-adjusted year of life saved compared with DS. <h3>Conclusions.</h3> —Our results suggest that for the preoperative detection of a 70% to 99% carotid stenosis, the combination of DS and MRA, supplemented by CA for disparate results, is associated with the lowest long-term morbidity and mortality and has a favorable cost-effectiveness ratio. The combination of tests, or DS alone when MRA is not available, could potentially replace the current practice of using CA alone in the preoperative evaluation of patients with symptomatic carotid stenosis. (<i>JAMA</i>. 1995;274:888-893)