The prevalence of tympanostomy tubes in children in the United States, 1988.

Information from the 1988 National Health Interview Survey Medical Device Implant Supplement was used to obtain the first population estimates of the prevalence of implanted tympanostomy tubes, a common treatment for otitis media. The prevalence rate was estimated to be 13 per 1000 children aged younger than 18 years. Statistically significant differences in prevalence were found for sex (boys, 15/1000; girls, 10/1000), race (Whites, 15/1000; others, 4/1000), and activity level ("limited," 44/1000; others, 11/1000). Thirty percent of the tubes were replacements; infection was the reason for 75% of the original implants. The morbidity and costs associated with tympanostomy tubes are of public health importance.

The prevalence of internal orthopedic fixation devices in children in the United States, 1988.

This study provides the first estimated prevalence of implanted orthopedic fixation devices (e.g., pins or wires) among children in the United States, based on the Medical Device Implant Supplement to the 1988 National Health Interview Survey. The overall prevalence was 27 per 10,000 children younger than 18 years; prevalence was highest (59/10,000) among those aged 12 to 17 years. The lower extremities were the most frequent body site (43%) and injury was the leading specific reason for implantation (37%). Some (10%) were replacement implants.

National survey of self-reported breast implants: 1988 estimates.

This report provides the first population-based national estimates of the prevalence of adult women with breast implants in the U.S. These findings are based on the Medical Device Implant Supplement to the 1988 National Health Interview Survey. The overall prevalence was 33 implant recipients (95% confidence limits [CL]: 26 to 40) per 10,000 women. Almost three-fourths had two implants: prevalence peaked at 85 (59 to 100) per 10,000 for women aged 35 to 44 years. Implant prevalence was statistically significantly greater among women who were white, residents of the south and west, had higher family income, and had more education, who worked, or were slim. Among current implants, 87% were original. Complications were reported for 24% of the implants.

Orthopedic implant devices: prevalence and sociodemographic findings from the 1988 National Health Interview Survey.

National population-based estimates on the magnitude and distribution of orthopedic implant devices in the United States have not been available to date. The Food and Drug Administration's Center for Devices and Radiological Health (FDA/CDRH) collaborated with the Centers for Disease Control's National Center for Health Statistics (CDC/NCHS) in the design and conduct of a nationwide medical device implant survey to generate the first national population-based prevalence estimates of orthopedic implant devices. A Medical Device Implant Supplement to the 1988 National Health Interview Survey was administered in personal household interviews to a national sample of 47,485 households, which included 122,310 individuals. An estimated 6.5 million orthopedic implants were in use in the general US population in 1988, including 1.6 million artificial joints and 4.9 million fixation devices. As a group, orthopedic implants comprised nearly half of all medical device implants in use, 43.4%. The majority of artificial joint recipients were 65 years of age or older, white, and male. The majority of fixation device recipients were less than 45 years of age, white, and male. The limitations and strengths of these population-based estimates are discussed.

How frequently are home pregnancy tests used? Results from the 1988 National Maternal and Infant Health Survey.

Many women use commercially available home pregnancy tests to determine their pregnancy status before seeking professional health care. Despite the increasing popularity of these products, no national estimates have been reported to date on their frequency of use. We analyzed available data from the 1988 National Maternal and Infant Health Survey to determine the frequency of use of home pregnancy tests during recent pregnancies of women of varying sociodemographic backgrounds. Approximately 33 percent (N = 4700) of the women surveyed used such a device. Use was most frequent among women who were white, married, over age 39 years, highly educated, or had a high family income. We conclude that home pregnancy testing appears to be a frequent procedure, especially among women of high socioeconomic background.

Use of diagnostic ultrasound, X-ray examinations, and electronic fetal monitoring in perinatal medicine.

Obstetrical technologies such as electronic fetal monitoring (EFM) and selected diagnostic imaging procedures can be integral components of perinatal care. The Center for Devices and Radiological Health, a unit within the Food and Drug Administration, collaborated with the National Center for Health Statistics in the design and conduct of a National Maternal and Infant Health Survey to collect information from prenatal care providers, hospitals, and mothers on the use of EFM, diagnostic ultrasound, and x-ray examinations during pregnancy, labor, and delivery. A pretest, conducted some months before the survey began, showed that 78.8% of the pregnancies surveyed received a diagnostic ultrasound examination during pregnancy. Approximately 58.3% of the ultrasound-exposed mothers had two or more such examinations. Approximately 10.1% of the ultrasound examinations were performed in the first trimester of pregnancy, 57.0% in the second trimester, and 32.9% in the third trimester. The most common indication for an ultrasound examination was to establish dates or gestational age. Approximately 15.3% of the pregnancies surveyed received an x-ray examination. Approximately 74.6% of the pregnancies were monitored with EFM during labor. External EFM was used alone during 54.9% of the labors and along with internal EFM during 19.7% of the labors. The implications of these pretest findings are discussed, along with a review of the medical literature on the safety and effectiveness of these medical device technologies.

Use of diagnostic imaging procedures and fetal monitoring devices in the care of pregnant women.

Medical devices and diagnostic imaging procedures such as ultrasound, X-rays, and electronic fetal monitoring devices are used in the medical care of many pregnant women today. The responsibility for the safety and effectiveness of these diagnostic technologies is shared by a number of Public Health Service agencies, one of which is the Center for Devices and Radiological Health (CDRH), a unit within the Food and Drug Administration. The CDRH collaborated with the National Center for Health Statistics (NCHS) in conducting a study of recent trends in the uses of diagnostic ultrasound, medical X-rays, and electronic fetal monitoring devices in the medical care of pregnant women. This study used data from the 1980 National Natality and Fetal Mortality Surveys and the 1987 pretest to the National Maternal and Infant Health Survey. Hospitals and prenatal care providers of the pregnant women contributed information regarding the use of these medical devices. Between 1980 and 1987, ultrasound use more than doubled, increasing from 33.5 percent of pregnancies in 1980 to 78.8 percent in 1987 (P less than 0.001). More ultrasound examinations were performed earlier in gestation in 1987 than in 1980, with 10.1 percent being performed during the first trimester in 1987, compared with 6.9 percent in 1980 (P less than 0.001). Use of external electronic fetal monitoring devices during delivery also increased significantly between 1980 and 1987, from 33.5 percent to 74.6 percent (P less than 0.001). Use of medical X-rays among women with live births remained relatively unchanged, 15.0 percent in 1980 and 15.3 percent in 1987 (P = .282). The implications of these trends are discussed.

Knowledge in relation to cadaveric kidney donation in urban blacks.

A questionnaire survey of black residents of an inner city in the South was conducted to examine the relationship between awareness (knowledge) of cadaver kidney donation programs (CKDP) and socio-demographic factors. Nearly 64 percent of the respondents were unfamiliar with CKDP. Of the respondents who had previously been aware of CKDP, older persons were more likely than younger persons (under age 20) to have heard about cadaver kidney donation. Education and occupation were positively correlated with familiarity of cadaver kidney donation; those with higher education (college graduates) and professional or managerial occupations were more likely to know of it (54 percent and 53 percent respectively). Knowledge did not differ by sex. This finding is striking in that it delineates a target population within the black community for education to increase donorship.