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Overdiagnosis

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https://www.readbyqxmd.com/read/28799687/upfront-immunohistochemistry-improves-specificity-of-helicobacter-pylori-diagnosis-a-french-pathology-laboratory-point-of-view
#1
Florent Ginestet, Briac Guibourg, Laurent Doucet, Jérémie Théreaux, Michel Robaszkiewicz, Pascale Marcorelles, Arnaud Uguen
BACKGROUND: There is no consensus about the histopathologic methods to detect Helicobacter pylori in gastric biopsies to date. We aimed to question about the value of upfront anti-H. pylori immunohistochemistry in this field. MATERIAL AND METHODS: We led a retrospective study about the rate of H. pylori-positive gastric biopsies before and after the implementation of upfront immunohistochemistry, the inter-rater and intermethods agreements in H. pylori identification about Hematoxylin-Eosin Saffron (HES), Giemsa, and immunohistochemistry stains and the histopathologic features associated with low amounts of H...
August 11, 2017: Helicobacter
https://www.readbyqxmd.com/read/28787726/disturbances-of-embodiment-as-core-phenomena-of-depression-in-clinical-practice
#2
Otto Doerr-Zegers, Leonor Irarrázaval, Adrian Mundt, Virginie Palette
This paper proposes a phenomenological approach to the diagnosis of depression, with the aim of overcoming the broadness and nonspecificity of the concept of major depressive disorder (MDD) in current systems of diagnostic classification of mental disorders. Firstly, we outline the methodological limitations of the current classification systems for the diagnosis of MDD. Secondly, we offer a conceptual differentiation between a "symptomatological" versus a "phenomenological" diagnosis of depression. Thirdly, we propose characteristic "disturbances of embodiment" as the fundamental phenomena of "core depression", which manifest themselves in 3 dimensions: embodied self, embodied intentionality, and embodied time...
August 9, 2017: Psychopathology
https://www.readbyqxmd.com/read/28784609/understanding-cardiac-troponin-part-1-avoiding-troponinitis
#3
REVIEW
Richard Body, Edward Carlton
Cardiac troponin (cTn) is a highly specific biomarker of myocardial injury and is central to the diagnosis of acute myocardial infarction (AMI). By itself, however, cTn cannot identify the cause of myocardial injury. 'Troponinitis' is the condition that leads clinicians to falsely assign a diagnosis of AMI based only on the fact that a patient has an elevated cTn concentration. There are many causes of myocardial injury other than AMI. Clinicians are required to differentiate myocardial injury caused by AMI from other causes...
August 7, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28784118/cardiovascular-riskprofile-imaging-and-gender-specific-disorders-crew-imago-rationale-and-design-of-a-multicenter-cohort-study
#4
Gerbrand A Zoet, Cindy Meun, Laura Benschop, Eric Boersma, Ricardo P J Budde, Bart C J M Fauser, Christianne J M de Groot, Aad van der Lugt, Angela H E M Maas, Karl G M Moons, Jeanine E Roeters van Lennep, Jolien W Roos-Hesselink, Eric A P Steegers, Bas B van Rijn, Joop S E Laven, Arie Franx, Birgitta K Velthuis
BACKGROUND: Reproductive disorders, such as polycystic ovary syndrome (PCOS), primary ovarian insufficiency (POI) and hypertensive pregnancy disorders (HPD) like pre-eclampsia (PE), are associated with an increased risk of cardiovascular disease (CVD). Detection of early signs of cardiovascular disease (CVD), as well as identification of risk factors among women of reproductive age which improve cardiovascular risk prediction, is a challenge and current models might underestimate long-term health risks...
August 7, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28783215/sensitization-to-dust-mite-defines-different-phenotypes-of-asthma-a-multicenter-study
#5
Silvia Ruggieri, Gaspare Drago, Valeria Longo, Paolo Colombo, Martin Balzan, David Bilocca, Christopher Zammit, Stephen Montefort, Gianluca Scaccianoce, Giuseppina Cuttitta, Giovanni Viegi, Fabio Cibella
BACKGROUND: Indoor allergens are risk factors for asthma: thus, the characterization of indoor air quality is important for studying environment-health relationships in children. In particular, Dermatophagoides pteronyssinus is the dominant allergen for asthma. We cross-sectionally investigated the relationships among respiratory symptoms and function, airway inflammation, allergen sensitization and indoor allergen concentration. METHODS: One hundred thirty two children aging 10-14 years and living in a Southern Mediterranean area were evaluated by parental questionnaires...
August 7, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28780499/how-to-feed-a-baby-recovering-from-necrotising-enterocolitis-when-maternal-milk-is-not-available
#6
REVIEW
Nicholas D Embleton, Stefan P Zalewski
Necrotising enterocolitis (NEC) is a devastating disease with significant mortality and serious adverse outcomes in at least 50% including short gut and poor neurodevelopment. Research and management are complicated by a lack of robust clinical markers, and without histological confirmation, there is a risk of both underdiagnosis and overdiagnosis. Interunit variations in the thresholds for surgical referral, laparotomy and postmortem rates mean the actual incidence is difficult to determine, especially because the histological term 'NEC' is used in practice to describe a heterogeneous clinical syndrome...
August 5, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28765860/assessing-the-efficacy-of-cancer-screening
#7
Gemma Jacklyn, Katy Bell, Andrew Hayen
BACKGROUND: Population-based cancer screening has been established for several types of cancer in Australia and internationally. Screening may perform differently in practice from randomised controlled trials, which makes evaluating programs complex. MATERIALS AND METHODS: We discuss how to assess the evidence of benefits and harms of cancer screening, including the main biases that can mislead clinicians and policy makers (such as volunteer, lead-time, length-time and overdiagnosis bias)...
July 26, 2017: Public Health Research & Practice
https://www.readbyqxmd.com/read/28765858/history-development-and-future-of-cancer-screening-in-australia
#8
Ian N Olver, David Roder
INTRODUCTION: The aim of screening an asymptomatic population for cancer is to achieve better health outcomes, particularly a population survival benefit. Australia has three population screening programs: the National Cervical Screening Program (NCSP), BreastScreen Australia and the National Bowel Cancer Screening Program (NBCSP). METHODS: We reviewed the history and development of the three programs. NCSP: Women have a Pap smear every 2 years from age 18-20, or 2 years after first becoming sexually active, until age 69...
July 26, 2017: Public Health Research & Practice
https://www.readbyqxmd.com/read/28765855/what-is-overdiagnosis-and-why-should-we-take-it-seriously-in-cancer-screening
#9
Stacy M Carter, Alexandra Barratt
Overdiagnosis occurs in a population when conditions are diagnosed correctly but the diagnosis produces an unfavourable balance between benefits and harms. In cancer screening, overdiagnosed cancers are those that did not need to be found because they would not have produced symptoms or led to premature death. These overdiagnosed cancers can be distinguished from false positives, which occur when an initial screening test suggests that a person is at high risk but follow-up testing shows them to be at normal risk...
July 26, 2017: Public Health Research & Practice
https://www.readbyqxmd.com/read/28763304/chronic-inflammatory-demyelinating-polyneuropathy
#10
Richard A Lewis
PURPOSE OF REVIEW: As a syndrome with typical and atypical cases, chronic inflammatory demyelinating polyneuropathy (CIDP) has been a difficult disorder to diagnose and treat. The pathophysiologic basis for CIDP has not been established, contributing to the challenges in dealing with these patients. However, as one of only a handful of treatable peripheral neuropathies, there has been a tendency to diagnose CIDP to attempt a therapeutic intervention. We are also aware that there has also been overtreatment of some patients...
July 29, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28762545/epigenetic-risk-score-improves-prostate-cancer-risk-assessment
#11
Leander Van Neste, Jack Groskopf, William E Grizzle, George W Adams, Mark S DeGuenther, Peter N Kolettis, James E Bryant, Gary P Kearney, Michael C Kearney, Wim Van Criekinge, Sandra M Gaston
BACKGROUND: Early detection of aggressive prostate cancer (PCa) remains crucial for effective treatment of patients. However, PCa screening remains controversial due to a high rate of overdiagnosis and overtreatment. To better reconcile both objectives, more effective methods for assessing disease severity at the time of diagnosis are needed. METHODS: The relationship between DNA-methylation and high-grade PCa was examined in a cohort of 102 prospectively enrolled men who received standard 12-core prostate biopsies...
August 1, 2017: Prostate
https://www.readbyqxmd.com/read/28762124/a-randomized-trial-of-early-detection-of-clinically-significant-prostate-cancer-proscreen-study-design-and-rationale
#12
Anssi Auvinen, Antti Rannikko, Kimmo Taari, Paula Kujala, Tuomas Mirtti, Anu Kenttämies, Irina Rinta-Kiikka, Terho Lehtimäki, Niku Oksala, Kim Pettersson, Teuvo L Tammela
The current evidence of PSA-based prostate cancer screening shows a reduction in cause-specific mortality, but with substantial overdiagnosis. Recently, new developments in detection of clinically relevant prostate cancer include multiple kallikreins as biomarkers besides PSA, and multiparametric magnetic resonance imaging (mpMRI) for biopsy decision. They offer opportunities for improving the outcomes in screening, particularly reduction in overdiagnosis and higher specificity for potentially lethal cancer...
July 31, 2017: European Journal of Epidemiology
https://www.readbyqxmd.com/read/28753870/outcomes-of-prostate-specific-antigen-based-prostate-cancer-screening-among-men-using-nonsteroidal-anti-inflammatory-drugs
#13
Teemu Johannes Murtola, Arla M Vettenranta, Kirsi Talala, Kimmo Taari, Ulf-Håkan Stenman, Teuvo L J Tammela, Anssi Auvinen
BACKGROUND: The Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC), the largest component of the European Randomized Study of Screening for Prostate Cancer (ERSPC), showed a smaller, nonsignificant reduction in prostate cancer-specific mortality by systematic prostate-specific antigen (PSA)-based screening compared with the overall ERSPC results. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce inflammation and also PSA elevations due to intraprostatic inflammation...
March 24, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28753866/diagnostic-and-prognostic-microrna-biomarkers-for-prostate-cancer-in-cell-free-urine
#14
Jacob Fredsøe, Anne K I Rasmussen, Anni R Thomsen, Peter Mouritzen, Søren Høyer, Michael Borre, Torben F Ørntoft, Karina D Sørensen
BACKGROUND: Widespread use of prostate-specific antigen (PSA) testing for prostate cancer (PC) detection has led to extensive overdiagnosis and overtreatment. Urine-based microRNA (miRNA) biomarkers could be useful in PC diagnosis and prognosis. OBJECTIVE: To train and validate urine-based microRNA (miRNA) biomarkers that may assist in PC diagnosis and prognosis. DESIGN, SETTING, AND PARTICIPANTS: We profiled the expression levels of 92 miRNAs via reverse transcriptase-poymerase chain reaction in cell-free urine samples from 29 patients with benign prostatic hyperplasia (BPH) and 215 patients with clinically localized PC (cohort 1)...
March 9, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28753850/detection-of-prostate-cancer-using-a-multistep-approach-with-prostate-specific-antigen-the-stockholm-3-test-and-targeted-biopsies-the-sthlm3-mri-project
#15
Tobias Nordström, Wolfgang Picker, Markus Aly, Fredrik Jäderling, Jan Adolfsson, Peter Ström, Erik Skaaheim Haug, Martin Eklund, Stefan Carlsson, Henrik Grönberg
There is a distinct need for clinical improvements to the pipeline for prostate detection. The aim of the STHLM3 magnetic resonance imaging (MRI) study is to provide evidence of an improved and structured multistep pipeline for prostate cancer detection using the bloodbased Stockholm 3 test and MRI to achieve better specificity and reduce the risk of overdiagnosis.
March 28, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28753831/balancing-overdiagnosis-and-early-detection-of-prostate-cancer-using-the-stockholm-3-model
#16
Tobias Nordström, Henrik Grönberg, Jan Adolfsson, Markus Aly, Martin Eklund
The S3M (Stockholm-3 Model) test improves discrimination for high-grade (Gleason score ≥ 7) prostate cancer compared with prostate-specific antigen (PSA) testing. Published results from the Stockholm-3 study represent a snapshot of possible outcomes for prostate cancer detection using the S3M test. In this brief report, we show how the full range of cancer detection rates and percent saved biopsies depend on the chosen S3M cut-off for recommending prostate biopsy. Using data from the Stockholm-3 validation cohort (n=47 688), we calculated the cancer detection rates and percent saved biopsies for various S3M test cut-offs in men with PSA ≥1ng/ml...
December 19, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28753803/the-stockholm-3-sthlm3-model-can-improve-prostate-cancer-diagnostics-in-men-aged-50-69-yr-compared-with-current-prostate-cancer-testing
#17
Martin Eklund, Tobias Nordström, Markus Aly, Jan Adolfsson, Peter Wiklund, Yvonne Brandberg, James Thompson, Fredrik Wiklund, Johan Lindberg, Joseph C Presti, Mark StLezin, Mark Clements, Lars Egevad, Henrik Grönberg
Prostate cancer screening is associated with low specificity, unnecessary biopsies, and overdiagnosis. We have previously shown that the Stockholm-3 model (S3M) can reduce biopsies compared with using prostate-specific antigen (PSA) ≥3ng/ml as an indication for biopsy. Urologists in today's current prostate cancer testing (CPT) have access to numerous variables in addition to PSA (eg, age, ethnicity, family history, free PSA, PSA velocity, digital rectal examination, and prostate volume) to support biopsy decisions...
November 23, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28749202/abbreviated-breast-mri-for-screening-women-with-dense-breast-the-ea1141-trial
#18
Christiane K Kuhl
Early diagnosis improves survival of women with breast cancer. Mammographic screening improves early diagnosis of breast cancer. And yet, there appears to be room for improvement. Major shortcomings of mammographic screening are overdiagnosis of prognostically unimportant cancer, as well as underdiagnosis of cancers that are indeed relevant. Failure to detect biologically relevant breast cancer with mammographic screening is driven by host-related factors, i.e. breast tissue density, but also tumour-related factors: Biologically relevant cancers may exhibit imaging features that renders them indistinguishable from normal or benign breast tissue on mammography...
July 27, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28742226/documentation-of-penicillin-adverse-drug-reactions-in-electronic-health-records-inconsistent-use-of-allergy-and-intolerance-labels
#19
Joshua M Inglis, Gillian E Caughey, William Smith, Sepehr Shakib
BACKGROUND: The majority of patients with penicillin allergy labels tolerate penicillins. Inappropriate avoidance of penicillin is associated with increased hospitalisation, infections and healthcare costs. AIMS: To examine the documentation of penicillin adverse drug reactions (ADR) in a large-scale hospital-based electronic health record. METHODS: Penicillin ADRs were extracted from 96,708 patient records in the Enterprise Patient Administration System in South Australia...
July 25, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28734396/spectrum-of-subsolid-pulmonary-nodules-and-overdiagnosis
#20
Barry D Hutchinson, Andre L Moreira, Jane P Ko
No abstract text is available yet for this article.
July 2017: Seminars in Roentgenology
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