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Damian Warzecha, Eliza Kobryń, Marta Bagińska, Dorota Bomba-Opoń
BACKGROUND: Fetal growth restriction (FGR) is an unclearly defined condition described as a fetal weight which is too low in relation to gestational age. It is recognized in 10-15% of singleton pregnancies and can lead to severe complications, including stillbirth. To reduce the adverse fetal and neonatal outcomes, many medical interventions are being introduced by obstetricians. These, like all medical procedures, may induce further complications, such as preterm labor and its consequences...
July 19, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Brandon Labarge, Vonn Walter, Eugene J Lengerich, Henry Crist, Dipti Karamchandani, Nicole Williams, David Goldenberg, Darrin V Bann, Joshua I Warrick
The incidence of thyroid cancer has risen dramatically in the past few decades. The cause of this is unclear, but several lines of evidence indicate it is largely due to overdiagnosis, the diagnosis of tumors that would have never manifest clinically if untreated. Practices leading to overdiagnosis may relate to defensive medicine. In this study, we evaluated the association between malpractice climate and incidence of thyroid, breast, prostate, colon, and lung cancer in U.S. states from 1999-2012 using publicly available government data...
2018: PloS One
Gokhan Kirlik, Rao Gullapalli, Warren D'Souza, Gazi Md Daud Iqbal, Michael Naslund, Jade Wong, John Papadimitrou, Steve Roys, Nilesh Mistry, Hao Zhang
Prostate cancer is the most frequently diagnosed cancer in men in the United States. The current main methods for diagnosing prostate cancer include prostate-specific antigen test and transrectal biopsy. Prostate-specific antigen screening has been criticized for overdiagnosis and unnecessary treatment, and transrectal biopsy is an invasive procedure with low sensitivity for diagnosis. We provided a quantitative tool using supervised learning with multiparametric imaging to be able to accurately detect cancer foci and its aggressiveness...
2018: Cancer Informatics
Emma English, Erna Lenters-Westra
Diagnosing and monitoring the treatment of people with diabetes is a global issue and uses considerable resources in laboratories and clinics worldwide. Hemoglobin A1c (HbA1c) has been the mainstay of monitoring glycemic control in people with diabetes for many years and more recently it has been advocated as a diagnostic tool for type 2 diabetes mellitus (T2DM). Good analytical performance is key to the successful use of any laboratory test, but is critical when using the test to diagnose disease, especially when the potential number of diagnoses could exceed 500 million people...
July 12, 2018: Critical Reviews in Clinical Laboratory Sciences
Seong-Woo Choi, So-Yeon Ryu, Mi-Ah Han, Jong Park
Recently, breast cancer prevalence has increased in South Korea. In this study, we investigated the correlation between breast cancer prevalence and socioeconomic status. This study enrolled 27,331 people who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) IV-VI (2007-2015). In addition, we obtained data from the Korean Statistical Information Service (KSIS) on the breast cancer age-standardized incidence rate (AIR), the age-standardized mortality rate (AMR), the number of women screened, and the number of newly diagnosed patients...
2018: PloS One
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
Diego R Da Silva, Kevin J Gaddis, Stephen Hess, Adam I Rubin
Glomus tumors are soft tissue neoplasms, which are most frequently encountered in the nail unit and generally straightforward to diagnose by histopathology. The typical clinical presentation is that of a circular violaceous or erythematous lesion within the nail bed. However, there are rare variants of glomus tumors which may pose diagnostic challenges because of the presence of unusual histologic features. Herein we report such a glomus tumor that demonstrates the rare combination of both myxoid and symplastic change...
April 2018: Dermatopathology (Basel, Switzerland)
Kei Miyazaki
American Heart Association/the American College of Cardiology and nine other professional organizations have issued a new hypertension clinical practice guideline (CPG) on November 2017, which has lowered the hypertension threshold to 130/80 mmHg. American Academy of Family Medicine has decided to not endorse this new CPG for various reasons including flaws in CPG development process and a limited additional benefit for lower treatment targets. The major concern was intellectual conflict of interest (COI)...
July 2018: Journal of General and Family Medicine
Yichao Han, Hecheng Li
Lung cancer is the most frequently diagnosed cancer and the most common cause of cancer death globally, of which 85% is non-small cell lung cancer (NSCLC). Early detection of NSCLC is essential to identify potential individuals for radical cure. Although low-dose computed tomography (LDCT) is recommended as standard screening with a mortality reduction of 20%, it displays a high false positive rate that poses an issue of overdiagnosis. MicroRNAs (miRNAs) are a group of small non-coding RNAs acting as important regulators in post-transcriptional gene expression and have been studied for their extensive role as novel biomarkers in NSCLC...
May 2018: Journal of Thoracic Disease
Vivek Podder, Binod Dhakal, Gousia Ummae Salma Shaik, Kaushik Sundar, Madhava Sai Sivapuram, Vijay Kumar Chattu, Rakesh Biswas
INTRODUCTION: Precision medicine aims to focus on meeting patient requirements accurately, optimizing patient outcomes, and reducing under-/overdiagnosis and therapy. We aim to offer a fresh perspective on accuracy driven “age-old precision medicine” and illustrate how newer case-based blended learning ecosystems (CBBLE) can strengthen the bridge between age-old precision approaches with modern technology and omics-driven approaches. METHODOLOGY: We present a series of cases and examine the role of precision medicine within a “case-based blended learning ecosystem” (CBBLE) as a practicable tool to reduce overdiagnosis and overtreatment...
July 10, 2018: Healthcare (Basel, Switzerland)
Igor Brikun, Deborah Nusskern, Andrew Decatus, Eric Harvey, Lin Li, Diha Freije
Background: Early screening for prostate cancer (PCA) remains controversial because of overdiagnosis and overtreatment of clinically insignificant cancers. Even though a number of diagnostic tests have been developed to improve on PSA testing, there remains a need for a more informative non-invasive test for PCA. The objective of this study is to identify a panel of DNA methylation markers suitable for a non-invasive diagnostic test from urine DNA collected following a digital rectal exam (DRE) and/or from first morning void (FV)...
2018: Clinical Epigenetics
Bich-May Nguyen, Kenneth W Lin, Ranit Mishori
Background: Overscreening occurs when people without symptoms undergo tests for diseases and the results will not improve their health. In this commentary, we examine three examples of how campaigns to screen and treat specific vascular, metabolic, and oncologic diseases in asymptomatic individuals have produced substantial overdiagnosis and may well have contributed to more harm than good. These conditions were chosen because they may not be as well known as other cases such as screening for breast or prostate cancer...
2018: Public Health Reviews
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
Amit Pandya, Elaine M Caoili, Farah Jawad-Makki, Ashish P Wasnik, Prasad R Shankar, Ron Bude, Megan R Haymart, Matthew S Davenport
Background: The 2015 American Thyroid Association (ATA) guidelines have been proposed to aid in the management of thyroid nodules by determining whether FNA is indicated. Objective: To determine if the ATA guidelines contribute to the overdiagnosis of thyroid cancer. Patients and methods: This was a retrospective cohort study of ultrasound imaged thyroid nodules (n=1,947) consecutively aspirated at a tertiary care center from 10/1/2009 to 2/22/2016...
July 3, 2018: Journal of Clinical Endocrinology and Metabolism
Jacqui Thornton
No abstract text is available yet for this article.
July 6, 2018: BMJ: British Medical Journal
Francesco Sardanelli, Rubina M Trimboli, Tibor Tot
No abstract text is available yet for this article.
July 5, 2018: JAMA Oncology
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
Joseph D Coppock, Brian C Willis, Mark H Stoler, Anne M Mills
BACKGROUND: In situ hybridization for human papillomavirus (HPV) messenger RNA (HPV RNA ISH) recently was introduced as an ancillary tool in the diagnosis of cervical squamous intraepithelial lesions, and can aid in the distinction between low-grade squamous intraepithelial lesions (LSILs) versus reactive/negative biopsies. Prior work has shown that up to one-half of cases originally diagnosed as LSIL are reclassified as negative/reactive by expert consensus review of morphology, and negative HPV RNA ISH results most often correlate with an expert diagnosis of negative/reactive...
July 5, 2018: Cancer Cytopathology
Robert B M Landewé
Overdiagnosis is a term coined by experts in cancer screening to point to indolent cancers detected by screening that would have never led to manifest health problems. Overdiagnosis leads to unnecessary medical care (overtreatment), anxiety and cost. In rheumatology overdiagnosis and overtreatment are hardly discussed but likely present. This viewpoint examines how our prevailing views on the management of inflammatory rheumatic diseases may relate to overdiagnosis and overtreatment. Six paradigms of modern rheumatology will be discussed: early diagnosis, intensive treatment, remission, prognosis and risk stratification, evidence-based rheumatology, and precision medicine...
July 4, 2018: Annals of the Rheumatic Diseases
Jennifer A Hirst, Maria Dla Vazquez Montes, Clare J Taylor, José M Ordóñez-Mena, Emma Ogburn, Vanshika Sharma, Brian Shine, Tim James, Fd Richard Hobbs
BACKGROUND: Chronic kidney disease (CKD) is diagnosed using the estimated glomerular filtration rate (eGFR) and the urinary albumin:creatinine ratio (ACR). The eGFR is calculated from serum creatinine levels using the Modification of Diet in Renal Disease (MDRD) or Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. AIM: To compare the performance of one versus two eGFR/ACR measurements, and the impact of equation choice, on CKD diagnosis and classification...
July 2, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
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