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Preventing overdiagnosis

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https://www.readbyqxmd.com/read/30321005/-how-to-avoid-overmedicalization-of-the-elderly-patient
#1
F Benoît, K Segers, C Sergeant, J Robberecht, J M Meyts, R Karmali, M Surquin
Over-medicalization is a broad concept, which also concerns the elderly patient. It encompasses both over-diagnosis and over-treatment. An increasing awareness of this issue has emerged since 2013, with the first " Preventing Overdiagnosis " conference. Currently, Evidence-Based Medicine does not prevent over-diagnosis. Indeed, the presence of geriatric characteristics such as multiple comorbidities, polypharmacy and frailty can lead to misdiagnosis and to potentially deleterious treatment. Subclinical hypothyroidism and Alzheimer's disease are two examples of pitfalls in the interpretation of biological and para-clinical data that may lead to the administration of useless treatment...
2018: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/30260288/too-much-of-a-good-thing-overdiagnosis-or-overestimating-risk-in-preventive-genomic-screening
#2
Karen M Meagher, Jonathan S Berg
No abstract text is available yet for this article.
September 27, 2018: Personalized Medicine
https://www.readbyqxmd.com/read/30199360/-febrile-seizures-questions-and-answers
#3
Alfredo Cerisola, Eugenia Chaibún, Melania Rosas, Lucía Cibils
A febrile seizure occurs in association with fever in a child aged 6 to 60 months, without central nervous system infection or other known cause of acute seizures in a child without a prior history of afebrile seizures. Febrile seizures occur in about 2-5% of children. Central nervous system infections should be considered in patients with febrile seizures, even though the frequency of this possibility is low, especially when patients do not return to baseline. Simple febrile seizures are considered benign events and there are clear guidelines about evaluation and management, but the evaluation of complex febrile seizures is controversial...
2018: Medicina
https://www.readbyqxmd.com/read/30177417/age-related-hearing-loss-and-cognitive-decline-the-potential-mechanisms-linking-the-two
#4
REVIEW
Yasue Uchida, Saiko Sugiura, Yukiko Nishita, Naoki Saji, Michihiko Sone, Hiromi Ueda
The amount of attention to age-related hearing loss (ARHL) has been growing, not only from the perspective of being one of the most common health conditions affecting older adults, but also from the perspective of its relation to cognition. Results from a number of epidemiological and laboratory studies have demonstrated a significant link between ARHL and cognitive decline. The Lancet International Commission on Dementia, Prevention, Intervention, and Care has estimated that mid-life hearing loss, if eliminated, might decrease the risk of dementia by nine percent, since hearing loss is a modifiable age-associated condition linked to dementia...
August 31, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/30140926/clinical-and-genetic-complexities-of-left-ventricular-noncompaction-preventing-overdiagnosis-in-a-disease-we-do-not-understand
#5
Samantha Barratt Ross, Christopher Semsarian
No abstract text is available yet for this article.
August 15, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/30108054/overdiagnosis-in-primary-care-framing-the-problem-and-finding-solutions
#6
REVIEW
Minal S Kale, Deborah Korenstein
Overdiagnosis, is defined as the diagnosis of a condition that, if unrecognized, would not cause symptoms or harm a patient during his or her lifetime, and it is increasingly acknowledged as a consequence of screening for cancer and other conditions. Because preventive care is a crucial component of primary care, which is delivered to the broad population, overdiagnosis in primary care is an important problem from a public health perspective and has far reaching implications. The scope of overdiagnosis as a result of services delivered in primary care is unclear, though overdiagnosis of indolent breast, prostate, thyroid, and lung cancers is well described and overdiagnosis of chronic kidney disease, depression, and attention-deficit/hyperactivity disorder is also recognized...
August 14, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/30105393/evaluating-shared-decision-making-for-lung-cancer-screening
#7
Alison T Brenner, Teri L Malo, Marjorie Margolis, Jennifer Elston Lafata, Shynah James, Maihan B Vu, Daniel S Reuland
Importance: The US Preventive Services Task Force recommends that shared decision making (SDM) involving a thorough discussion of benefits and harms should occur between clinicians and patients before initiating lung cancer screening (LCS) with low-dose computed tomography. The Centers for Medicare & Medicaid Services require an SDM visit using a decision aid as a prerequisite for LCS coverage. However, little is known about how SDM about LCS occurs in practice. Objective: To assess the quality of SDM about the initiation of LCS in clinical practice...
October 1, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/30057105/analysis-of-clinical-benefit-harms-and-cost-effectiveness-of-screening-women-for-abdominal-aortic-aneurysm
#8
Michael J Sweeting, Katya L Masconi, Edmund Jones, Pinar Ulug, Matthew J Glover, Jonathan A Michaels, Matthew J Bown, Janet T Powell, Simon G Thompson
BACKGROUND: A third of deaths in the UK from ruptured abdominal aortic aneurysm (AAA) are in women. In men, national screening programmes reduce deaths from AAA and are cost-effective. The benefits, harms, and cost-effectiveness in offering a similar programme to women have not been formally assessed, and this was the aim of this study. METHODS: We developed a decision model to assess predefined outcomes of death caused by AAA, life years, quality-adjusted life years, costs, and the incremental cost-effectiveness ratio for a population of women invited to AAA screening versus a population who were not invited to screening...
August 11, 2018: Lancet
https://www.readbyqxmd.com/read/29998344/screening-for-peripheral-artery-disease-and-cardiovascular-disease-risk-assessment-with-the-ankle-brachial-index-us-preventive-services-task-force-recommendation-statement
#9
Susan J Curry, Alex H Krist, Douglas K Owens, Michael J Barry, Aaron B Caughey, Karina W Davidson, Chyke A Doubeni, John W Epling, Alex R Kemper, Martha Kubik, C Seth Landefeld, Carol M Mangione, Michael Silverstein, Melissa A Simon, Chien-Wen Tseng, John B Wong
Importance: Peripheral artery disease (PAD) is a manifestation of atherosclerosis in the lower limbs. It can impair walking and, in severe cases, can lead to tissue loss, infection, and amputation. In addition to morbidity directly caused by PAD, patients with PAD are at increased risk for cardiovascular disease (CVD) events, because atherosclerosis is a systemic disease that also causes coronary and cerebrovascular events. Objective: To update the 2013 US Preventive Services Task Force (USPSTF) recommendation on screening for PAD and CVD risk with the ankle-brachial index (ABI)...
July 10, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29987082/mental-health-messages-in-prominent-mental-health-apps
#10
Lisa Parker, Lisa Bero, Donna Gillies, Melissa Raven, Barbara Mintzes, Jon Jureidini, Quinn Grundy
PURPOSE: Many who seek primary health care advice about mental health may be using mobile applications (apps) claiming to improve well-being or relieve symptoms. We aimed to identify how prominent mental health apps frame mental health, including who has problems and how they should be managed. METHODS: We conducted a qualitative content analysis of advertising material for mental health apps found online in the United States, the United Kingdom, Canada, and Australia during late 2016...
July 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29978189/cost-effectiveness-and-benefit-to-harm-ratio-of-risk-stratified-screening-for-breast-cancer-a-life-table-model
#11
Nora Pashayan, Steve Morris, Fiona J Gilbert, Paul D P Pharoah
Importance: The age-based or "one-size-fits-all" breast screening approach does not take into account the individual variation in risk. Mammography screening reduces death from breast cancer at the cost of overdiagnosis. Identifying risk-stratified screening strategies with a more favorable ratio of overdiagnoses to breast cancer deaths prevented would improve the quality of life of women and save resources. Objective: To assess the benefit-to-harm ratio and the cost-effectiveness of risk-stratified breast screening programs compared with a standard age-based screening program and no screening...
July 5, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29946705/defining-estimating-and-communicating-overdiagnosis-in-cancer-screening
#12
Louise Davies, Diana B Petitti, Lynn Martin, Meghan Woo, Jennifer S Lin
The toll of inadequate health care is well-substantiated, but recognition is mounting that "too much" is also possible. Overdiagnosis represents one harm of too much medicine, but the concept can be confusing: It is often conflated with related harms (such as overtreatment, misclassification, false-positive results, and overdetection) and is difficult to measure because it cannot be directly observed. Because the U.S. Preventive Services Task Force (USPSTF) issues screening recommendations aimed largely at healthy persons, it has a particular interest in understanding harms related to screening, especially but not limited to overdiagnosis...
July 3, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29903796/should-women-aged-70-74-be-invited-to-participate-in-screening-mammography-a-report-on-two-australian-community-juries
#13
Chris Degeling, Alexandra Barratt, Sanchia Aranda, Robin Bell, Jenny Doust, Nehmat Houssami, Jolyn Hersch, Ruben Sakowsky, Vikki Entwistle, Stacy M Carter
OBJECTIVE: To elicit informed views from Australian women aged 70-74 regarding the acceptability of ceasing to invite women their age to participate in government-funded mammography screening (BreastScreen). DESIGN: Two community juries held in 2017. SETTING: Greater Sydney, a metropolis of 4.5 million people in New South Wales, Australia. PARTICIPANTS: 34 women aged 70-74 with no personal history of breast cancer, recruited by random digit dialling and previously randomly recruited list-based samples...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29809244/identifying-patients-for-whom-lung-cancer-screening-is-preference-sensitive-a-microsimulation-study
#14
Tanner J Caverly, Pianpian Cao, Rodney A Hayward, Rafael Meza
Background: Many health systems are exploring how to implement low-dose computed tomography (LDCT) screening programs that are effective and patient-centered. Objective: To examine factors that influence when LDCT screening is preference-sensitive. Design: State-transition microsimulation model. Data Sources: Two large randomized trials, published decision analyses, and the SEER (Surveillance, Epidemiology, and End Results) cancer registry...
July 3, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29801018/prostate-specific-antigen-based-screening-for-prostate-cancer-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#15
REVIEW
Joshua J Fenton, Meghan S Weyrich, Shauna Durbin, Yu Liu, Heejung Bang, Joy Melnikow
Importance: Prostate cancer is the second leading cause of cancer death among US men. Objective: To systematically review evidence on prostate-specific antigen (PSA)-based prostate cancer screening, treatments for localized prostate cancer, and prebiopsy risk calculators to inform the US Preventive Services Task Force. Data Sources: Searches of PubMed, EMBASE, Web of Science, and Cochrane Registries and Databases from July 1, 2011, through July 15, 2017, with a surveillance search on February 1, 2018...
May 8, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29801017/screening-for-prostate-cancer-us-preventive-services-task-force-recommendation-statement
#16
David C Grossman, Susan J Curry, Douglas K Owens, Kirsten Bibbins-Domingo, Aaron B Caughey, Karina W Davidson, Chyke A Doubeni, Mark Ebell, John W Epling, Alex R Kemper, Alex H Krist, Martha Kubik, C Seth Landefeld, Carol M Mangione, Michael Silverstein, Melissa A Simon, Albert L Siu, Chien-Wen Tseng
Importance: In the United States, the lifetime risk of being diagnosed with prostate cancer is approximately 13%, and the lifetime risk of dying of prostate cancer is 2.5%. The median age of death from prostate cancer is 80 years. Many men with prostate cancer never experience symptoms and, without screening, would never know they have the disease. African American men and men with a family history of prostate cancer have an increased risk of prostate cancer compared with other men. Objective: To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on prostate-specific antigen (PSA)-based screening for prostate cancer...
May 8, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29688040/commentary-acog-practice-bulletin-july-2017-breast-cancer-risk-assessment-and-screening-in-average-risk-women
#17
Victoria Mango, Yolanda Bryce, Elizabeth Anne Morris, Elisabetta Gianotti, Katja Pinker
Screening mammography reduces breast cancer mortality in average-risk women. However, adverse consequences include false-positive findings possibly leading to benign breast biopsies and patient anxiety. There is also potential for overdiagnosis and overtreatment. Differences in how to balance benefits and harms have led to varying recommendations by the U.S. Preventive Services Task Force, the American Cancer Society, the National Comprehensive Cancer Network and the American College of Radiology/Society of Breast Imaging...
October 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29603505/pr%C3%A3-cising-definitions-as-a-way-to-combat-overdiagnosis
#18
Wendy A Rogers, Mary J Walker
Roughly, overdiagnosis (ODx) occurs when people are harmed by receiving diagnoses (often accompanied by interventions) that do not benefit them, usually because the diagnosed conditions do not pose a threat to their health. ODx is a theoretical as well as a practical problem as it relates to definitions of disease. Elsewhere, it has been argued that disease is a vague concept and that this vagueness may contribute to ODx. In response, we develop a stipulative or précising definition of disease, for the specific purpose of decreasing or preventing ODx...
October 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29554463/modeling-ductal-carcinoma-in-situ-dcis-an-overview-of-cisnet-model-approaches
#19
Nicolien T van Ravesteyn, Jeroen J van den Broek, Xiaoxue Li, Harald Weedon-Fekjær, Clyde B Schechter, Oguzhan Alagoz, Xuelin Huang, Donald L Weaver, Elizabeth S Burnside, Rinaa S Punglia, Harry J de Koning, Sandra J Lee
BACKGROUND: Ductal carcinoma in situ (DCIS) can be a precursor to invasive breast cancer. Since the advent of screening mammography in the 1980's, the incidence of DCIS has increased dramatically. The value of screen detection and treatment of DCIS, however, is a matter of controversy, as it is unclear the extent to which detection and treatment of DCIS prevents invasive disease and reduces breast cancer mortality. The aim of this paper is to provide an overview of existing Cancer Intervention and Surveillance Modelling Network (CISNET) modeling approaches for the natural history of DCIS, and to compare these to other modeling approaches reported in the literature...
April 2018: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29441421/diagnostic-error-in-stroke-reasons-and-proposed-solutions
#20
REVIEW
Ekaterina Bakradze, Ava L Liberman
PURPOSE OF REVIEW: We discuss the frequency of stroke misdiagnosis and identify subgroups of stroke at high risk for specific diagnostic errors. In addition, we review common reasons for misdiagnosis and propose solutions to decrease error. RECENT FINDINGS: According to a recent report by the National Academy of Medicine, most people in the USA are likely to experience a diagnostic error during their lifetimes. Nearly half of such errors result in serious disability and death...
February 13, 2018: Current Atherosclerosis Reports
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