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https://www.readbyqxmd.com/read/28095020/current-status-of-ventilation-perfusion-scintigraphy-for-suspected-pulmonary-embolism
#1
Darlene Metter, Mark Tulchinsky, Leonard M Freeman
OBJECTIVE: The purpose of this article is to outline recent progress made in ventilation-perfusion (V/Q) scintigraphy imaging techniques and the interpretation systems used for the diagnosis of pulmonary embolism (PE). Various state-of-the-art approaches that can be selected according to the needs dictated by the medical practice environment and specific patient groups are presented. CONCLUSION: Although advances in tomographic imaging have certainly improved the sensitivity of V/Q scans for the diagnosis of PE, they may lead to overdiagnosis by revealing small and clinically insignificant PEs...
January 17, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28087170/clostridium-difficile-rates-in-asymptomatic-and-symptomatic-hospitalized-patients-using-nucleic-acid-testing
#2
Cynthia Truong, Lee F Schroeder, Rajiv Gaur, Victoria Emma Anikst, Ikuko Komo, Colleen Watters, Erin McCalley, Carole Kulik, David Pickham, Nancy J Lee, Niaz Banaei
BACKGROUND: The Clostridium difficile rate in symptomatic patients represents both those with C. difficile infection (CDI) and those with colonization. To predict the extent of CDI overdiagnosis, we compared the asymptomatic colonization rate to the symptomatic positivity rate in hospitalized patients using nucleic acid testing. METHODS: Between July 2014 and April 2015, formed stool samples were collected from asymptomatic patients after admission to 3 hospital wards at the Stanford Hospital...
January 3, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28083633/-systematic-errors-in-clinical-studies-a%C3%A2-comprehensive-survey
#3
REVIEW
W A Golder
Systematic errors and related phenomena represent an intrinsic challenge to the quality of clinical research. As a consequence even otherwise methodologically demanding studies may produce results that systematically differ from the true values. Systematic errors relating to investigative medicine are divided into six groups according to their affiliation with the consecutive chronological sections of the study. Bias can occur in preliminary literature research in the field, specifying the study design and selecting the study sample, measuring exposure and outcome, analyzing the data, interpreting the analyses and publishing the results...
January 12, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28081797/comparison-of-the-cardiothoracic-ratio-between-postmortem-and-antemortem-computed-tomography
#4
Hidemi Okuma, Wataru Gonoi, Masanori Ishida, Go Shirota, Shigeaki Kanno, Yukako Shintani, Hiroyuki Abe, Masashi Fukayama, Kuni Ohtomo
As postmortem imaging has gained prominence as a supplement to traditional autopsy, it is important to understand the normal postmortem changes to enable the accurate evaluation of postmortem imaging. No studies have evaluated the postmortem changes in cardiothoracic ratio (CTR) compared with antemortem images in the same subjects. We studied 147 consecutive subjects who underwent antemortem and postmortem CT, and autopsy. Postmortem CT was performed <23h after death and was followed by autopsy. The subjects were divided into three groups: normal heart, old myocardial infarction, and CPR-treated hearts...
January 2017: Legal Medicine
https://www.readbyqxmd.com/read/28078168/concurrent-validity-of-caffeine-problems-and-diagnostic-criteria-for-substance-use-disorders
#5
Elizabeth Harstad, Georgios Sideridis, Lon Sherritt, Lydia A Shrier, Rosemary Ziemnik, Sharon Levy
Background: The DSM-5 proposes caffeine use disorder (CUD) as a condition for further study. The objective of this study was to report on the prevalence of CUD and rates of endorsement for each substance use disorder (SUD) criterion in relation to caffeine compared to alcohol and marijuana in a sample of adolescents presenting for medical care in the primary, adolescent, and substance use clinics at an academic medical center. Methods: A convenience sample of patients (N = 213; 66.7% female) aged 12-17 presenting for medical care completed the Composite Diagnostic Interview-Substance Abuse Module questionnaire, with questions regarding use of caffeine, alcohol, and marijuana...
December 1, 2016: Journal of Caffeine Research
https://www.readbyqxmd.com/read/28073996/estimate-of-false-positive-breast-cancer-diagnoses-from-accuracy-studies-a-systematic-review
#6
REVIEW
Nereo Segnan, Silvia Minozzi, Antonio Ponti, Cristina Bellisario, Sara Balduzzi, Marien González-Lorenzo, Silvia Gianola, Paola Armaroli
BACKGROUND: False-positive histological diagnoses have the same consequences of overdiagnosis in terms of unnecessary treatment. The aim of this systematic review is to assess their frequency at needle core biopsy (CB) and/or surgical excision of the breast. METHODS: PubMed, Embase, Cochrane Library were systematically searched up to 30 October 2015. Eligibility criteria: cross-sectional studies assessing diagnostic accuracy of CB compared with surgical excision; studies assessing reproducibility of pathologists reading the same slides...
January 10, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28073150/the-impact-of-overdiagnosis-on-the-selection-of-efficient-lung-cancer-screening-strategies
#7
Summer S Han, Kevin Ten Haaf, William D Hazelton, Vidit N Munshi, Jihyoun Jeon, Saadet A Erdogan, Colden Johanson, Pamela M McMahon, Rafael Meza, Chung Yin Kong, Eric J Feuer, Harry J de Koning, Sylvia K Plevritis
The U.S. Preventive Services Task Force (USPSTF) recently updated their national lung screening guidelines and recommended low-dose computed tomography (LDCT) for lung cancer (LC) screening through age 80. However, the risk of overdiagnosis among older populations is a concern. Using four comparative models from the Cancer Intervention and Surveillance Modeling Network, we evaluate the overdiagnosis of the screening program recommended by USPSTF in the U.S. 1950 birth cohort. We estimate the number of LC deaths averted by screening (D) per overdiagnosed case (O), yielding the ratio D/O, to quantify the trade-off between the harms and benefits of LDCT...
January 10, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28062405/presence-of-multiple-spondyloarthritis-spa-features-is-important-but-not-sufficient-for-a-diagnosis-of-axial-spondyloarthritis-data-from-the-spondyloarthritis-caught-early-space-cohort
#8
Z Ez-Zaitouni, P A C Bakker, M van Lunteren, I J Berg, R Landewé, M van Oosterhout, M Lorenzin, D van der Heijde, F A van Gaalen
OBJECTIVES: Concerns have been raised about overdiagnosis of axial spondyloarthritis (axSpA). We investigated whether patients with chronic back pain (CBP) of short duration and multiple SpA features are always diagnosed with axSpA by the rheumatologist, and to what extent fulfilment of the Assessment of SpondyloArthritis International Society (ASAS) axSpA criteria is associated with an axSpA diagnosis. METHODS: Baseline data from 500 patients from the SPondyloArthritis Caught Early cohort which includes patients with CBP (≥3 months, ≤2 years, onset <45 years) were analysed...
January 6, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28059158/thyroid-cancer-overdiagnosis-of-papillary-carcinoma-who-benefits
#9
Juan P Brito, Ian D Hay
No abstract text is available yet for this article.
January 6, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28049578/vascular-tumours-of-the-breast-a-comprehensive-review-with-focus-on-diagnostic-challenges-encountered-in-the-core-biopsy-setting
#10
Paula S Ginter, Patrick J McIntire, Sandra J Shin
Vascular proliferations of the breast comprise a spectrum of benign and malignant lesions. In limited samples, such as core needle biopsies (CNB), these lesions may be difficult to distinguish due to significant overlap in morphological features. As the treatment and prognosis of these entities vary widely, it is important for pathologists to consider a complete differential diagnosis and correctly synthesise histological features, results of adjunctive immunohistochemical studies, and pertinent clinical and imaging information, to render an accurate diagnosis in such limited samples...
December 31, 2016: Pathology
https://www.readbyqxmd.com/read/28049113/update-on-pediatric-overuse
#11
Eric R Coon, Paul C Young, Ricardo A Quinonez, Daniel J Morgan, Sanket S Dhruva, Alan R Schroeder
As concerns over health care-related harms and costs continue to mount, efforts to identify and combat medical overuse are needed. Although much of the recent attention has focused on health care for adults, children are also harmed by overuse. Using a structured PubMed search and manual tables of contents review, we identified important articles on pediatric overuse published in 2015. These articles were evaluated according to the quality of the methods, the magnitude of clinical effect, and the number of patients potentially affected and were categorized into overdiagnosis, overtreatment, and overutilization...
January 3, 2017: Pediatrics
https://www.readbyqxmd.com/read/28046017/development-and-external-validation-of-the-korean-prostate-cancer-risk-calculator-for-high-grade-prostate-cancer-comparison-with-two-western-risk-calculators-in-an-asian-cohort
#12
Jae Young Park, Sungroh Yoon, Man Sik Park, Hoon Choi, Jae Hyun Bae, Du Geon Moon, Sung Kyu Hong, Sang Eun Lee, Chanwang Park, Seok-Soo Byun
PURPOSE: We developed the Korean Prostate Cancer Risk Calculator for High-Grade Prostate Cancer (KPCRC-HG) that predicts the probability of prostate cancer (PC) of Gleason score 7 or higher at the initial prostate biopsy in a Korean cohort (http://acl.snu.ac.kr/PCRC/RISC/). In addition, KPCRC-HG was validated and compared with internet-based Western risk calculators in a validation cohort. MATERIALS AND METHODS: Using a logistic regression model, KPCRC-HG was developed based on the data from 602 previously unscreened Korean men who underwent initial prostate biopsies...
2017: PloS One
https://www.readbyqxmd.com/read/28038710/differentiated-squamous-intraepithelial-lesion-dsil-like-changes-in-the-epidermis-overlying-anogenital-melanocytic-nevi-a-diagnostic-pitfall
#13
Kvetoslava Michalova, Dmitry V Kazakov, Michael Michal, Ladislav Hadravsky, Denisa Kacerovska, Boris Rychly, Marketa Miesbauerova, Michal Michal
BACKGROUND: Differentiated squamous intraepithelial lesion (dSIL) is morphologically and immunohistochemically analogous in the whole anogenital region. dSIL is a premalignant lesion frequently misinterpreted histopathologically as a benign dermatosis. The authors describe a peculiar change in the basal cell layer of the epidermis/epithelium overlying anogenital melanocytic nevi that may histopathologically imitate dSIL. The aim of this study is to familiarize the pathologists with this pitfall to avoid its possible overdiagnosis as dysplasia...
February 2017: Annals of Diagnostic Pathology
https://www.readbyqxmd.com/read/28038345/a-bayesian-model-for-estimating-multi-state-disease-progression
#14
Shiwen Shen, Simon X Han, Panayiotis Petousis, Robert E Weiss, Frank Meng, Alex A T Bui, William Hsu
A growing number of individuals who are considered at high risk of cancer are now routinely undergoing population screening. However, noted harms such as radiation exposure, overdiagnosis, and overtreatment underscore the need for better temporal models that predict who should be screened and at what frequency. The mean sojourn time (MST), an average duration period when a tumor can be detected by imaging but with no observable clinical symptoms, is a critical variable for formulating screening policy. Estimation of MST has been long studied using continuous Markov model (CMM) with Maximum likelihood estimation (MLE)...
December 22, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28029492/overdiagnosis-in-breast-imaging
#15
Andy Evans, Sarah Vinnicombe
The main harm of overdiagnosis is overtreatment. However a form of overdiagnosis also occurs when foci of cancer are found by imaging in addition to the symptomatic lesion when this leads to additional treatment which does not benefit the patient. Even if overtreatment is avoided, knowledge of the diagnosis can still cause psychological harm. Overdiagnosis is an inevitable effect of mammographic screening as the benefit comes from diagnosing breast cancer prior to clinical detectability. Estimates of the rate of overdiagnosis at screening are around 10%...
October 28, 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28026076/ethical-issues-with-colorectal-cancer-screening-a-systematic-review
#16
Bjørn Hofmann
RATIONALE, AIMS, AND OBJECTIVES: Colorectal cancer (CRC) screening is widely recommended and implemented. However, sometimes CRC screening is not implemented despite good evidence, and some types of CRC screening are implemented despite lack of evidence. The objective of this article is to expose and elucidate relevant ethical issues in the literature on CRC screening that are important for open and transparent deliberation on CRC screening. METHODS: An axiological question-based method is used for exposing and elucidating ethical issues relevant in HTA...
December 27, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28018875/diagnostic-accuracy-of-developmental-screening-in-primary-care-at-the-18-month-health-supervision-visit-a-cross-sectional-study
#17
Meta van den Heuvel, Cornelia M Borkhoff, Christine Koroshegyi, Weeda Zabih, Sijmen A Reijneveld, Jonathon Maguire, Catherine Birken, Patricia Parkin
BACKGROUND: Communication delays are often the first presenting problem in infants with a range of developmental disabilities. Our objective was to assess the validity of the 18-month Nipissing District Developmental Screen compared with the Infant Toddler Checklist, a validated tool for detecting expressive language and other communication delays. METHODS: A cross-sectional design was used. Children aged 18-20 months were recruited during scheduled health supervision visits...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/28012728/magnetic-resonance-imaging-in-the-new-paradigm-for-the-diagnosis-of-prostate-cancer
#18
J C Vilanova, V Catalá
For various reasons, prostate cancer is a major public health problem. It is a very common cancer, but has a very low mortality rate because it comprises two types of disease: one insignificant, indolent, and much more common, and the other aggressive, significant, and much less common. The routine diagnostic approach to prostate cancer has been systematic blind biopsies, which has low detection rates and might detect low risk, insignificant prostate cancer, leading to overdiagnosis and overtreatment of indolent cancers...
December 21, 2016: Radiología
https://www.readbyqxmd.com/read/28007294/-the-frequency-of-cancer-in-france-most-recent-data-and-trends
#19
Laureen Ribassin-Majed, Gwénaël Le-Teuff, Catherine Hill
We present and discuss recent data on the frequency of cancer in France and on cancer survival. In the male population, the incidence of prostate and head and neck cancers diminishes rapidly and the incidence of the other common cancers: lung and colorectal diminishes less markedly; cancer mortality decreases for most sites. In the female population, the incidence of breast cancer diminishes rapidly, the incidence of colorectal and uterus cancers diminish less markedly and the incidence of lung cancer increases very fast: the mortality trends are similar...
December 19, 2016: Bulletin du Cancer
https://www.readbyqxmd.com/read/28007017/research-on-medical-overuse-overdiagnosis-and-overtreatment-in-family-medicine-and-primary-care
#20
(no author information available yet)
No abstract text is available yet for this article.
December 2016: European Journal of General Practice
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