Publications by authors named "Anne Mackie"

15 Publications

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UK National Screening Committee's approach to reviewing evidence on artificial intelligence in breast cancer screening.

Lancet Digit Health 2022 07;4(7):e558-e565

Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.

Artificial intelligence (AI) could have the potential to accurately classify mammograms according to the presence or absence of radiological signs of breast cancer, replacing or supplementing human readers (radiologists). The UK National Screening Committee's assessments of the use of AI systems to examine screening mammograms continues to focus on maximising benefits and minimising harms to women screened, when deciding whether to recommend the implementation of AI into the Breast Screening Programme in the UK. Maintaining or improving programme specificity is important to minimise anxiety from false positive results. When considering cancer detection, AI test sensitivity alone is not sufficiently informative, and additional information on the spectrum of disease detected and interval cancers is crucial to better understand the benefits and harms of screening. Although large retrospective studies might provide useful evidence by directly comparing test accuracy and spectrum of disease detected between different AI systems and by population subgroup, most retrospective studies are biased due to differential verification (ie, the use of different reference standards to verify the target condition among study participants). Enriched, multiple-reader, multiple-case, test set laboratory studies are also biased due to the laboratory effect (ie, radiologists' performance in retrospective, laboratory, observer studies is substantially different to their performance in a clinical environment). Therefore, assessment of the effect of incorporating any AI system into the breast screening pathway in prospective studies is required as it will provide key evidence for the effect of the interaction of medical staff with AI, and the impact on women's outcomes.
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http://dx.doi.org/10.1016/S2589-7500(22)00088-7DOI Listing
July 2022

Targeted screening in the UK: A narrow concept with broad application.

Lancet Reg Health Eur 2022 May 14;16:100353. Epub 2022 Apr 14.

UK National Screening Committee, Southside, 39 Victoria Street, London SW1H 0EU, UK.

A recent report on screening in the UK proposed that the responsibility for recommendations on population and targeted screening programmes should be held by one new integrated advisory body. There is no wide international consensus on the definition of targeted screening. Our review identified and compared the defining components of screening terms: targeted, population, selective, and cascade screening, and case finding. Definitions of targeted screening and population screening were clearly demarcated by the eligible population; targeted and selective screening were found to be conceptually interchangeable; cascade screening, whilst conceptually similar to targeted screening across several components, was only used within the context of genetic diseases. There was little consensus between different definitions of case finding. These comparisons contributed to an updated definition of targeted screening. Considerable overlap between definition components across terms implies that a broad range of disease areas may fall into the remit of the new advisory body.
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http://dx.doi.org/10.1016/j.lanepe.2022.100353DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9038565PMC
May 2022

The IARC Perspective on Cervical Cancer Screening. Reply.

N Engl J Med 2022 02;386(6):607-608

National Cancer Institute, Rockville, MD.

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http://dx.doi.org/10.1056/NEJMc2119177DOI Listing
February 2022

The projected impact of the COVID-19 lockdown on breast cancer deaths in England due to the cessation of population screening: a national estimation.

Br J Cancer 2022 05 2;126(9):1355-1361. Epub 2022 Feb 2.

UK National Screening Committee, Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London, SW1H 0EU, UK.

Background: Population breast screening services in England were suspended in March 2020 due to the COVID-19 pandemic. Here, we estimate the number of breast cancers whose detection may be delayed because of the suspension, and the potential impact on cancer deaths over 10 years.

Methods: We estimated the number and length of screening delays from observed NHS Breast Screening System data. We then estimated additional breast cancer deaths from three routes: asymptomatic tumours progressing to symptomatically diagnosed disease, invasive tumours which remain screen-detected but at a later date, and ductal carcinoma in situ (DCIS) progressing to invasive disease by detection. We took progression rates, prognostic characteristics, and survival rates from published sources.

Results: We estimated that 1,489,237 women had screening delayed by around 2-7 months between July 2020 and June 2021, leaving 745,277 outstanding screens. Depending on how quickly this backlog is cleared, around 2500-4100 cancers would shift from screen-detected to symptomatic cancers, resulting in 148-452 additional breast cancer deaths. There would be an additional 164-222 screen-detected tumour deaths, and 71-97 deaths from DCIS that progresses to invasive cancer.

Conclusions: An estimated 148-687 additional breast cancer deaths may occur as a result of the pandemic-related disruptions. The impact depends on how quickly screening services catch up with delays.
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http://dx.doi.org/10.1038/s41416-022-01714-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8808468PMC
May 2022

The IARC Perspective on Cervical Cancer Screening.

N Engl J Med 2021 11;385(20):1908-1918

From the International Agency for Research on Cancer, Lyon (V.B., W.P., B.I.I.R., I.M.M., B.L.-S.), and the National Public Health Agency, Saint-Maurice (F.F.H.) - both in France; the National Cancer Institute, Rockville, MD (N.W., M. Schiffman); Public Health England and Screening, London (A.M.); Amsterdam University Medical Centers, Amsterdam (J. Berkhof); VCS Foundation, Melbourne, VIC (J. Brotherton), Australia; Azienda Unità Sanitaria Locale - IRCCS Reggio Emilia, Reggio Emilia, Italy (P.G.R.); the University of Toronto, Toronto (R.K.); the American Cancer Society (R. Smith), Emory University (M.H.C.), and the Centers for Disease Control and Prevention (M. Saraiya) - all in Atlanta; the Center for the Study of the State and Society, and the National Scientific and Technical Research Council - both in Buenos Aires (S.A.); the Casablanca Cancer Registry, Casablanca, Morocco (K.B.); The Daffodil Centre, a joint venture between the Cancer Council NSW and the University of Sydney, King's Cross, NSW, Australia (K.C.); the University of Zimbabwe College of Health Sciences, Harare (Z.M.C.); Hospital Clínic de Barcelona, Barcelona (M.P.); PATH, Seattle (S. de Sanjosé); Karolinska Institutet, Stockholm (M.E.); McGill University, Montreal (E.F.); Teikyo University, and the National Cancer Center - both in Tokyo (C.H.); the University of Edinburgh, Edinburgh (C.S.H.); Hospital Universitario San Ignacio, Bogota, Colombia (R.M.); the National Cancer Institute, Bangkok, Thailand (S. Sangrajrang); Research Triangle Institute International, New Delhi, India (R. Sankaranarayanan); Chinese Academy of Medical Sciences, Beijing (F.Z.); and Sciensano, Brussels (M.A.).

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http://dx.doi.org/10.1056/NEJMsr2030640DOI Listing
November 2021

Half a Century of Wilson & Jungner: Reflections on the Governance of Population Screening.

Wellcome Open Res 2020 17;5:158. Epub 2020 Aug 17.

Instituto per lo Studio e la Prevenzione Oncologica, Firenze, Italy.

In their landmark report on the "Principles and Practice of Screening for Disease" (1968), Wilson and Jungner noted that the practice of screening is just as important for securing beneficial outcomes and avoiding harms as the formulation of principles. Many jurisdictions have since established various kinds of "screening governance organizations" to provide oversight of screening practice. Yet to date there has been relatively little reflection on the nature and organization of screening governance itself, or on how different governance arrangements affect the way screening is implemented and perceived and the balance of benefits and harms it delivers. An international expert policy workshop convened by Sturdy, Miller and Hogarth. While effective governance is essential to promote beneficial screening practices and avoid attendant harms, screening governance organizations face enduring challenges. These challenges are social and ethical as much as technical. Evidence-based adjudication of the benefits and harms of population screening must take account of factors that inform the production and interpretation of evidence, including the divergent professional, financial and personal commitments of stakeholders. Similarly, when planning and overseeing organized screening programs, screening governance organizations must persuade or compel multiple stakeholders to work together to a common end. Screening governance organizations in different jurisdictions vary widely in how they are constituted, how they relate to other interested organizations and actors, and what powers and authority they wield. Yet we know little about how these differences affect the way screening is implemented, and with what consequences. Systematic research into how screening governance is organized in different jurisdictions would facilitate policy learning to address enduring challenges. Even without such research, informal exchange and sharing of experiences between screening governance organizations can deliver invaluable insights into the social as well as the technical aspects of governance.
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http://dx.doi.org/10.12688/wellcomeopenres.16057.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468564PMC
August 2020

Screening for atrial fibrillation: waiting for randomised trial data.

BMJ 2019 06 4;365:l2383. Epub 2019 Jun 4.

UK National Screening Committee, London SE1 8UG, UK.

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http://dx.doi.org/10.1136/bmj.l2383DOI Listing
June 2019

Guidelines on the management of abnormal liver blood tests.

Gut 2018 01 9;67(1):6-19. Epub 2017 Nov 9.

Gwent Liver Unit, Royal Gwent Hospital, Newport, UK.

These updated guidelines on the management of abnormal liver blood tests have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines, which this document supersedes, were written in 2000 and have undergone extensive revision by members of the Guidelines Development Group (GDG). The GDG comprises representatives from patient/carer groups (British Liver Trust, Liver4life, PBC Foundation and PSC Support), elected members of the BSG liver section (including representatives from Scotland and Wales), British Association for the Study of the Liver (BASL), Specialist Advisory Committee in Clinical Biochemistry/Royal College of Pathology and Association for Clinical Biochemistry, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), Public Health England (implementation and screening), Royal College of General Practice, British Society of Gastrointestinal and Abdominal Radiologists (BSGAR) and Society of Acute Medicine. The quality of evidence and grading of recommendations was appraised using the AGREE II tool. These guidelines deal specifically with the management of abnormal liver blood tests in children and adults in both primary and secondary care under the following subheadings: (1) What constitutes an abnormal liver blood test? (2) What constitutes a standard liver blood test panel? (3) When should liver blood tests be checked? (4) Does the extent and duration of abnormal liver blood tests determine subsequent investigation? (5) Response to abnormal liver blood tests. They are not designed to deal with the management of the underlying liver disease.
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http://dx.doi.org/10.1136/gutjnl-2017-314924DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5754852PMC
January 2018

UK National Screening Committee Criteria: clarification of two misunderstandings.

Authors:
Anne Mackie

Eur J Hum Genet 2017 06 26;25(7):791. Epub 2017 Apr 26.

PHE Screening, Public Health England, London, UK.

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http://dx.doi.org/10.1038/ejhg.2017.56DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520068PMC
June 2017

PHE guidance does warn about PSA testing.

BMJ 2016 Aug 5;354:i4238. Epub 2016 Aug 5.

Public Health England, Wellington House, London SE1 8UG, UK.

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http://dx.doi.org/10.1136/bmj.i4238DOI Listing
August 2016

Anne Mackie: Optimistic, direct, and pragmatic.

Authors:
Anne Mackie

BMJ 2016 Jan 6;352:h6710. Epub 2016 Jan 6.

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http://dx.doi.org/10.1136/bmj.h6710DOI Listing
January 2016

Screening of competitive athletes to prevent sudden death: Think twice.

Authors:
Anne Mackie

Heart 2013 Mar 22;99(5):306-7. Epub 2012 Nov 22.

Imperial College Healthcare NHS Trust, Mint Wing, Centre Block G, South Wharf Road, London W2 1NY, UK.

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http://dx.doi.org/10.1136/heartjnl-2012-302412DOI Listing
March 2013

Reflection as part of continuous professional development for public health professionals: a literature review.

J Public Health (Oxf) 2013 Jun 17;35(2):308-12. Epub 2012 Oct 17.

UK National Screening Committee, London, UK.

Background: For many years, reflection has been considered good practice in medical education. In public health (PH), while no formal training or teaching of reflection takes place, it is expected as part of continuous professional development. This paper aims to identify reflective models useful for PH and to review published literature on the role of reflection in PH. The paper also aims to investigate the reported contribution, if any, of reflection by PH workers as part of their professional practice.

Methods: A review of the literature was carried out in order to identify reflective experience, either directly related to PH or in health education. Free text searches were conducted for English language papers on electronic bibliographic databases in September 2011. Thirteen papers met the inclusion criteria and were reviewed.

Results: There is limited but growing evidence to suggest reflection improves practice in disciplines allied to PH. No specific models are currently recommended or widely used in PH.

Conclusions: Health education literature has reflective models which could be applied to PH practice.
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http://dx.doi.org/10.1093/pubmed/fds083DOI Listing
June 2013

The Tn antigen-specific lectin from ground ivy is an insecticidal protein with an unusual physiology.

Plant Physiol 2003 Jul;132(3):1322-34

Department of Molecular Biotechnology, Ghent University, Coupure Links 653, 9000 Gent, Belgium.

Leaves of ground ivy (Glechoma hederacea) contain a lectin (called Gleheda) that is structurally and evolutionary related to the classical legume lectins. Screening of a population of wild plants revealed that Gleheda accounts for more than one-third of the total leaf protein in some clones, whereas it cannot be detected in other clones growing in the same environment. Gleheda is predominantly expressed in the leaves where it accumulates during early leaf maturation. The lectin is not uniformly distributed over the leaves but exhibits a unique localization pattern characterized by an almost exclusive confinement to a single layer of palisade parenchyma cells. Insect feeding trials demonstrated that Gleheda is a potent insecticidal protein for larvae of the Colorado potato beetle (Leptinotarsa decemlineata). Because Gleheda is not cytotoxic, it is suggested that the insecticidal activity is linked to the carbohydrate-binding specificity of the lectin, which as could be demonstrated by agglutination assays with different types of polyagglutinable human erythrocytes is specifically directed against the Tn antigen structure (N-acetylgalactosamine O-linked to serine or threonine residues of proteins).
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC167072PMC
http://dx.doi.org/10.1104/pp.103.023853DOI Listing
July 2003
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