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Overdiagnosis

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https://www.readbyqxmd.com/read/28647893/the-overdiagnosis-of-what-on-the-relationship-between-the-concepts-of-overdiagnosis-disease-and-diagnosis
#1
Bjørn Hofmann
Overdiagnosis and disease are related concepts. Widened conceptions of disease increase overdiagnosis and vice versa. This is partly because there is a close and complex relationship between disease and overdiagnosis. In order to address the problems with overdiagnosis, we may benefit from a closer understanding this relationship. Accordingly, the objective of this article is to elucidate the relationship between disease and overdiagnosis. To do so, the article starts with scrutinizing how overdiagnosis can explain the expansion of the concept of disease...
June 24, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28647216/characteristics-of-prostate-cancer-found-at-fifth-screening-in-the-european-randomized-study-of-screening-for-prostate-cancer-rotterdam-can-we-selectively-detect-high-grade-prostate-cancer-with-upfront-multivariable-risk-stratification-and-magnetic-resonance
#2
Arnout R Alberts, Ivo G Schoots, Leonard P Bokhorst, Frank-Jan H Drost, Geert J van Leenders, Gabriel P Krestin, Roy S Dwarkasing, Jelle O Barentsz, Fritz H Schröder, Chris H Bangma, Monique J Roobol
BACKGROUND: The harm of screening (unnecessary biopsies and overdiagnosis) generally outweighs the benefit of reducing prostate cancer (PCa) mortality in men aged ≥70 yr. Patient selection for biopsy using risk stratification and magnetic resonance imaging (MRI) may improve this benefit-to-harm ratio. OBJECTIVE: To assess the potential of a risk-based strategy including MRI to selectively identify men aged ≥70 yr with high-grade PCa. DESIGN, SETTING, AND PARTICIPANTS: Three hundred and thirty-seven men with prostate-specific antigen ≥3...
June 21, 2017: European Urology
https://www.readbyqxmd.com/read/28644335/practice-bulletin-number-179-breast-cancer-risk-assessment-and-screening-in-average-risk-women
#3
(no author information available yet)
Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about what age to start, what age to stop, and how frequently to recommend mammography screening in average-risk women (2-4)...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28644328/practice-bulletin-no-179-summary-breast-cancer-risk-assessment-and-screening-in-average-risk-women
#4
(no author information available yet)
Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about what age to start, what age to stop, and how frequently to recommend mammography screening in average-risk women (2-4)...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28624014/can-routine-chest-radiography-be-used-to-diagnose-mild-copd-a-nested-case-control-study
#5
A M den Harder, A M Snoek, T Leiner, W J Suyker, L M de Heer, R P J Budde, J W J Lammers, P A de Jong, M J A Gondrie
OBJECTIVES: To determine whether mild stage chronic obstructive pulmonary disease (COPD) can be detected on chest radiography without substantial overdiagnosis. METHODS: A retrospective nested case-control study (case:control, 1:1) was performed in 783 patients scheduled for cardiothoracic surgery who underwent both spirometry and a chest radiograph preoperative. Diagnostic accuracy of chest radiography for diagnosing mild COPD was investigated using objective measurements and overall appearance specific for COPD on chest radiography...
July 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28617483/epidemiology-of-chronic-kidney-disease-think-at-least-twice
#6
Pierre Delanaye, Richard J Glassock, Marc E De Broe
The introduction of the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines has substantially contributed to the early detection of different stages of chronic kidney disease (CKD). Several recent studies from different parts of the world mention a CKD prevalence of between 8 and 13%. There are several reasons the CKD prevalence found in a study of a particular population is clearly overestimated. The structure of the population pyramid (young or older age) of the study sample may result in high or low CKD prevalence...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28617107/thyroid-cancer-in-adolescents-and-young-adults
#7
Daniela Victoria Pirela Araque, Archie Bleyer, Juan P Brito
Despite the increase in thyroid cancer incidence among adolescents and young adults (AYAs), this group has received limited attention. We reviewed the epidemiology and challenges of thyroid cancer care among AYAs, and proposed a research agenda to improve their care. Thyroid cancer is the most common cancer in American adults 16-33 years of age. AYAs with thyroid cancer face challenges including overdiagnosis reduced healthcare access and inconsistent care. Successful treatment of these patients results in additional challenges due to ongoing side effects of treatment as well as lasting impacts on their quality of life...
June 15, 2017: Future Oncology
https://www.readbyqxmd.com/read/28614405/overdiagnosis-and-overtreatment-of-thyroid-cancer-a-population-based-temporal-trend-study
#8
Sabrina Jegerlehner, Jean-Luc Bulliard, Drahomir Aujesky, Nicolas Rodondi, Simon Germann, Isabelle Konzelmann, Arnaud Chiolero
BACKGROUND: The increase in incidence of thyroid cancer during the last decades without concomitant rise in mortality may reflect the growing detection of indolent forms of thyroid cancer, and may have fueled unnecessary thyroidectomies. Our aim was therefore, to compare recent secular trends in surgical intervention rate for thyroid cancer with the incidence and mortality of thyroid cancer to assess overdiagnosis and resulting overtreatment. METHODS: We conducted a population-based temporal trend study in Switzerland from 1998 to 2012...
2017: PloS One
https://www.readbyqxmd.com/read/28614085/a-multiparametric-approach-to-improve-upon-existing-prostate-cancer-screening-and-biopsy-recommendations
#9
Brian T Helfand, Carly A Conran, Jianfeng Xu, William J Catalona
PURPOSE OF REVIEW: To provide an overview of how genetic, serum, and urine biomarkers can help identify men at high risk for prostate cancer (PCa) and aggressive disease and men who would benefit from prostate biopsy. RECENT FINDINGS: Screening for PCa is controversial because of concerns about overdiagnosis and overtreatment of nonlife-threatening tumors. Therefore, an approach to screening that includes a detailed family history with genetic testing of risk single nucleotide polymorphisms and high-penetrance genetic variants should be considered...
June 12, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28594049/venous-thromboembolism-past-present-and-future
#10
Sam Schulman, Walter Ageno, Stavros V Konstantinides
Venous thromboembolism (VTE), the third most frequent acute cardiovascular syndrome, is associated with a considerable disease burden which continues to grow along with the longer life expectancy of the population worldwide. In the past century, parenteral heparin prophylaxis was established for hospitalised patients at elevated risk of VTE. More recently, non-vitamin K antagonist oral anticoagulants (NOACs) with a direct inhibiting effect on factor Xa or thrombin, underwent extensive testing in clinical trials and have been approved for patients undergoing hip or knee replacement...
June 8, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28591536/income-and-cancer-overdiagnosis-when-too-much-care-is-harmful
#11
H Gilbert Welch, Elliott S Fisher
Income has long been known to be an important determinant of health. Four decades ago, the Whitehall study of British civil servants revealed that higher employment grades were associated with better physical and mental health and lower mortality. In 2016, an analysis in which data from U.S. tax..
June 8, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28587433/statsensor-i-point-of-care-creatinine-analyzer-may-identify-patients-at-high-risk-of-contrast-induced-nephropathy
#12
Akitoshi Inoue, Norihisa Nitta, Shinichi Ohta, Katsuji Imoto, Michio Yamasaki, Mitsuru Ikeda, Kiyoshi Murata
The current study assessed the accuracy of the StatSensor-i (STA) point-of-care creatinine analyzer prior to and following adjustment (offset correction) by linear regression scatter plots produced by the reference samples from patients and volunteers for detecting high risk of contrast-induced nephropathy in patients with an estimated glomerular filtration rate <45 ml/min/1.73 m(2). Blood samples were obtained from 233 consecutive outpatients scheduled for contrast-enhanced CT studies. Of the 233 patients, 123 patient samples were evaluated prior to adjustment and the other 110 following adjustment...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28585332/inadequate-adherence-to-swedish-guidelines-for-uncomplicated-lower-urinary-tract-infections-among-adults-in-general-practice
#13
Heidi Lindbäck, Johan Lindbäck, Åsa Melhus
In a primary care study of urinary tract infections (UTIs) performed 2008 in Uppsala County, Sweden, 43% of the patients were culture negative. In order to investigate the background to the observed overdiagnosis of UTI, study invitations were sent to the previously included patients. A total of 256 patients (88% women) approved to participate. Patient charts and recorded laboratory data were reviewed. Two or more of the cardinal symptoms were reported in 53% of the women and in 19% of the men. A dipstick test was performed in 93% of the consultations...
June 6, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28580707/a-classifier-integrating-plasma-biomarkers-and-radiological-characteristics-for-distinguishing-malignant-from-benign-pulmonary-nodules
#14
Yanli Lin, Qixin Leng, Zhengran Jiang, Maria A Guarnera, Yun Zhou, Xueqi Chen, Heping Wang, Wenxian Zhou, Ling Cai, HongBin Fang, Jie Li, Hairong Jin, Linghui Wang, Shaoqiong Yi, Wei Lu, David Evers, Carol B Fowle, Yun Su, Feng Jiang
Lung cancer is primarily caused by cigarette smoking and the leading cancer killer in the USA and across the world. Early detection of lung cancer by low-dose CT (LDCT) can reduce the mortality. However, LDCT dramatically increases the number of indeterminate pulmonary nodules (PNs), leading to overdiagnosis. Having a definitive preoperative diagnosis of malignant PNs is clinically important. Using microarray and droplet digital PCR to directly profile plasma miRNA expressions of 135 patients with PNs, we identified 11 plasma miRNAs that displayed a significant difference between patients with malignant versus benign PNs...
June 4, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28557900/controversies-in-venous-thromboembolism
#15
Suman Yadam, Anand Popuri, Yousef Hattab, Tariq Cheema
Numerous controversies exist in the diagnosis of venous thromboembolism despite all the guidelines that are currently available. Screening of malignancy in venous thromboembolism has been a debated issue, as it has not been shown to change mortality. Calf vein thrombosis is also a controversial topic, but evidence points to risk stratifying those patients. Overdiagnosis, most notably from the finding of subsegmental pulmonary embolism, ultimately requires evaluating the risk and benefit for each patient. In addition, treatment of upper extremity deep vein thrombosis is a challenging scenario that is quite common in clinical practice...
July 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28555155/review-of-factors-related-to-the-thyroid-cancer-epidemic
#16
REVIEW
Yihao Liu, Lei Su, Haipeng Xiao
Thyroid cancer is the most common endocrine cancer, of which the incidence has dramatically increased worldwide in the past few decades. The reasons for the observed rapid increase still are not fully understood, but evidence suggests that overdiagnosis, with the advancement in detection methods and screening policies, is not the sole driver of the substantial increase of the incidence. However, the effect of environmental/lifestyle factors remains speculative other than that of radiation exposure at a young age...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28553923/-gluten-free-diet-is-for-some-a-necessity-for-others-a-lifestyle
#17
Iben Møller Jønsson, Gitte Leth Møller, Anders Pærregaard
This review provides a brief overview of the gluten-related conditions coeliac disease (CD), wheat allergy (WA), and non-coeliac gluten sensitivity (NCGS). NCGS is a new entity which includes individuals who report symptoms when exposed to gluten and benefit from gluten-free diet, but do not have CD or WA. The concept NCGS is still controversial and a subject of considerable overdiagnosis, and consensus regarding diagnostic criteria is lacking. Furthermore, the overlap with irritable bowel syndrome is unsettled...
May 29, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28552708/recent-changes-in-prostate-cancer-screening-practices-and-prostate-cancer-epidemiology
#18
REVIEW
Daniel J Lee, Katherine Mallin, Amy J Graves, Sam S Chang, David F Penson, Matthew J Resnick, Daniel A Barocas
PURPOSE: Prostate-specific antigen (PSA) based screening for prostate cancer has had a significant impact on the epidemiology of the disease. Its use has been associated with a significant reduction in prostate cancer mortality, but has also resulted in the overdiagnosis and overtreatment of indolent prostate cancer, exposing many men to the harms of treatment without benefit. The U.S. Preventive Service Task Force (USPSTF) issued a recommendation against screening men over 75 in 2008, and against routine screening for all men in 2012, indicating that, in their interpretation, the harms of screening outweigh the benefits...
May 25, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28551942/-prostate-cancer-early-detection-using-psa-current-trends-and-recent-updates
#19
REVIEW
Arnon Lavi, Michael Cohen
Prostate cancer (Pca) is the most common malignancy in men and the second cause of death from cancer. The prostate specific antigen (PSA) assay has been used for Pca screening since the beginning of the 1990's and has brought a 40% reduction in mortality. Since Pca is a diverse disease, early detection can lead to overdetection and overtreatment. Pca treatment has significant adverse effects, namely incontinence and erectile dysfunction. How is it then that a simple and inexpensive test that probably caused the most significant reduction in mortality from cancer ever, is regarded to be "not recommended" by some health organizations? Why did the use of PSA testing fall drastically in the US in the last couple of years, while, at the same time, the tendency for diagnosis of higher risk diseases is noticed through large controlled studies, showing the efficacy of PSA testing in mortality reduction? Will PSA serve as a milestone for early detection and mass population screening in general? This review will deal with aspects of PSA screening and will bring the latest updates and dilemmas concerning this evolving topic...
March 2017: Harefuah
https://www.readbyqxmd.com/read/28550985/opioid-hypersensitivity-predictors-of-allergy-and-role-of-drug-provocation-testing
#20
Philip H Li, Kok Loong Ue, Annette Wagner, Ryszard Rutkowski, Krzysztof Rutkowski
BACKGROUND: True IgE-mediated hypersensitivity to opioids is rare and many reactions are due to direct mast cell degranulation. Opioid drug provocation testing (DPT) is the gold standard for diagnosis but is underutilized. OBJECTIVE: The objective of this study was to evaluate the clinical characteristics and predictors of opioid hypersensitivity, as well as outcomes of opioid DPT. METHODS: Patients referred for opioid DPT over the past 9 years were studied...
May 24, 2017: Journal of Allergy and Clinical Immunology in Practice
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