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Overdiagnosis

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https://www.readbyqxmd.com/read/28318818/twitch-mouth-pressure-for-detecting-respiratory-muscle-weakness-in-suspicion-of-neuromuscular-disorder
#1
Dante Brasil Santos, Gilbert Desmarais, Line Falaize, Adam Ogna, Sandrine Cognet, Bruno Louis, David Orlikowski, Hélène Prigent, Frédéric Lofaso
Twitch mouth pressure using magnetic stimulation of the phrenic nerves and an automated inspiratory trigger is a noninvasive, non-volitional assessment of diaphragmatic strength. Our aims were to validate this method in patients with suspected neuromuscular disease, to determine the best inspiratory-trigger pressure threshold, and to evaluate whether twitch mouth pressure decreased the overdiagnosis of muscle weakness frequently observed with noninvasive volitional tests. Maximal inspiratory pressure, sniff nasal pressure, and twitch mouth pressure were measured in 112 patients with restrictive disease and suspected neuromuscular disorder...
February 2, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28302568/mutational-profile-from-targeted-ngs-predicts-survival-in-ldct-screening-detected-lung-cancers
#2
Carla Verri, Cristina Borzi, Todd Holscher, Matteo Dugo, Andrea Devecchi, Katherine Drake, Stefano Sestini, Paola Suatoni, Elisa Romeo, Gabriella Sozzi, Ugo Pastorino, Mattia Boeri
BACKGROUND: The issue of overdiagnosis in low-dose computed tomography (LDCT)-screening trials could be addressed by the development of complementary biomarkers able to improve detection of aggressive disease. The mutation profile of LDCT screening-detected lung tumours is currently unknown. METHODS: Targeted next-generation sequencing was performed in 94 LDCT screening-detected lung tumours. Associations with clinicopathologic features, survival and the risk profile of a plasma microRNA signature classifier (MSC) were analyzed...
March 13, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28299948/how-to-conduct-research-on-overdiagnosis-a-keynote-paper-from-the-egprn-may-2016-tel-aviv
#3
John Brodersen
Overdiagnosis is a growing problem worldwide. Overdiagnosis is the diagnosis of deviations, abnormalities, risk factors, and pathologies that in themselves would never cause symptoms (this applies only to risk factors and pathology), would never lead to morbidity, and would never be the cause of death. Overdiagnosis is often misinterpreted as overutilization or overtreatment. Overutilization, overtreatment, and overdiagnosis are interrelated but three distinct topics. Overutilization (establishment of standard practice that does not provide net benefit) does not have to lead to overdiagnosis or overtreatment, but the risk exists...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/28299887/fibroepithelial-lesions-in-the-breast-of-adolescent-females-a-clinicopathological-study-of-54-cases
#4
Dara S Ross, Dilip D Giri, Muzaffar M Akram, Jeffrey P Catalano, Cristina Olcese, Kimberly J Van Zee, Edi Brogi
Fibroepithelial lesions (FELs) are the most frequent breast tumors in adolescent females. The pubertal hormonal surge could impact the growth and microscopic appearance of FELs in this age group. In this study, we evaluate the morphology and clinical behavior of FELs in adolescents. We searched the 1992-2012 pathology data base for FELs in females 18 years old or younger (F ≤18 years). Seven FELs from 1975 to 1983 were also included. Three pathologists reviewed all available material. Patient (pt) characteristics and follow-up information were obtained from electronic medical records...
March 2017: Breast Journal
https://www.readbyqxmd.com/read/28292224/universal-depression-screening-to-improve-depression-outcomes-in-primary-care-sounds-good-but-where-is-the-evidence
#5
Ramin Mojtabai
The 2016 recommendation statement by the U.S. Preventive Services Task Force (USPSTF) endorsed screening for depression in the general adult population. The recommendation was mainly based on studies that compared enhanced depression care that included depression screening with usual care. In contrast to the USPSTF recommendation, the 2013 guidelines from the Canadian Task Force on Preventive Health Care (CTFPHC) recommended against routine depression screening. The CTFPHC could not identify any studies comparing depression outcomes of usual care with and without the addition of routine depression screening...
March 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28278335/experience-of-us-patients-who-self-identify-as-having-an-overdiagnosed-thyroid-cancer-a-qualitative-analysis
#6
Louise Davies, Chase D Hendrickson, Gregory S Hanson
Importance: Overdiagnosis of cancer-the identification of cancers that are unlikely to progress-is a source of discomfort and challenge for patients, physicians, and health care systems. A major cause of this discomfort is the inability to know prospectively with certainty which cancers are overdiagnosed. In thyroid cancer, as patients have begun to understand this concept, some individuals are independently deciding not to intervene, despite this practice not yet being widely accepted...
March 9, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28255212/competitive-coronary-flow-between-the-native-left-anterior-descending-artery-and-left-internal-mammary-artery-graft-is-it-a-surrogate-angiographic-marker-of-over-or-unnecessary-revascularization-decision-in-daily-practice
#7
Pinar Dogan, Mevlut Serdar Kuyumcu, Emine Demiryapan, Fazil Arisoy, Ozcan Ozeke
Overdiagnosis and overtreatment are often thought of as relatively recent phenomena in modern medicine, influenced by a contemporary combination of technology, specialization, payment models, marketing, and supply-related demand. Several investigators have reported discrepancies between the angiographic and functional severity of coronary angiographic stenosis. However, the visual anatomic assessment of the coronary lesion severity continues in daily practice. We evaluated the consecutive all coronary angiograms performed between January 2015 and December 2015 and examined only patients who had previous coronary artery bypass grafting (CABG) to analyze the cases with regard to presence of the competitive flow (CF) between the native left anterior descending coronary artery (LAD) and left internal mammary artery (LIMA) graft...
March 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28250897/overdiagnosis-of-gastric-cancer-by-endoscopic-screening
#8
REVIEW
Chisato Hamashima
Gastric cancer screening using endoscopy has recently spread in Eastern Asian countries showing increasing evidence of its effectiveness. However, despite the benefits of endoscopic screening for gastric cancer, its major harms include infection, complications, false-negative results, false-positive results, and overdiagnosis. The most serious harm of endoscopic screening is overdiagnosis and this can occur in any cancer screening programs. Overdiagnosis is defined as the detection of cancers that would never have been found if there is no cancer screening...
February 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28250865/scintigraphic-evidence-for-overdiagnosis-of-small-pe-on-ct-pulmonary-angiography
#9
Yang Lu
A 68-year-old man with recent history of a fall presented with dyspnea on exertion, and underwent computed tomography pulmonary angiography (CTPA) for possible pulmonary embolism (PE). The CTPA was first read by the radiology resident as nondiagnostic for segmental PE. Subsequent planar perfusion (Q) images were normal; meanwhile, the attending radiologist revised the CTPA results as subsegmental PE in the left upper lobe. Further Q-SPECT images were obtained and fused with CTPA for clarification, which showed normal perfusion in the region of PE...
March 2017: Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28236497/overdiagnosis-incidental-findings-and-socrates-three-sieves
#10
EDITORIAL
Jean Raymond, Hélène Long, David J Roy
No abstract text is available yet for this article.
February 21, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28236001/-systematic-errors-in-clinical-studies-a%C3%A2-comprehensive-survey
#11
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...
February 24, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28216328/outcomes-of-prostate-cancer-screening-by-5-alpha-reductase-inhibitor-usage
#12
Teemu J Murtola, Anniina Virkku, Kirsi Talala, Ulf-Håkan Stenman, Kimmo Taari, Teuvo Lj Tammela, Anssi Auvinen
PURPOSE: Prostate cancer (PCa) screening with prostate-specific antigen (PSA) reduces PCa mortality, but leads to overdiagnosis of indolent PCa. Use of 5-alpha reductase inhibitors (5-ARIs) lowers PSA and in theory could affect performance of PSA-based screening. We evaluated outcomes of PCa screening among 5-ARI users. MATERIALS AND METHODS: The study was performed within the Finnish Randomized Study of Screening for Prostate Cancer. Of 80,454 men, 31,866 were randomized to be screened at four-year intervals during 1996-2004...
February 16, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28215847/prostate-cancer-screening-in-men-aged-50-to-69-years-sthlm3-a-prospective-population-based-diagnostic-study-gr%C3%A3-nberg-h-adolfsson-j-aly-m-nordstr%C3%A3-m-t-wiklund-p-brandberg-y-thompson-j-wiklund-f-lindberg-j-clements-m-egevad-l-eklund-m-lancet-oncol-2015-dec-16
#13
Eggener Scott, J Adolfsson, M Aly, T Nordström, P Wiklund, Y Brandberg, J Thompson, F Wiklund, J Lindberg, M Clements, L Egevad, M Eklund
BACKGROUND: The prostate-specific antigen (PSA) test is used to screen for prostate cancer but has a high false-positive rate that translates into unnecessary prostate biopsies and overdiagnosis of low-risk prostate cancers. We aimed to develop and validate a model to identify high-risk prostate cancer (with a Gleason score of at least 7) with better test characteristics than that provided by PSA screening alone. METHODS: The Stockholm 3 (STHLM3) study is a prospective, population-based, paired, screen-positive, diagnostic study of men without prostate cancer aged 50 to 69 years randomly invited by date of birth from the Swedish Population Register kept by the Swedish Tax Agency...
March 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28214381/the-value-of-reflectance-confocal-microscopy-in-diagnosis-of-flat-pigmented-facial-lesions-a-prospective-study
#14
E Wurm, G Pellacani, C Longo, H P Soyer, S Gonzalez, R Hofmann-Wellenhof, V Ahlgrimm-Siess, P Guitera, C Sinz, H Kittler
BACKGROUND: Flat pigmented facial lesions are difficult to diagnose even with dermatoscopy. It is controversial how additional information obtained by in vivo reflectance confocal microscopy (RCM) impacts the diagnosis and management. OBJECTIVE: To examine what in vivo reflectance confocal microscopy of flat pigmented facial lesions adds to clinical examination using dermatoscopy including digital dermatoscopic monitoring. METHODS: We prospectively collected 70 cases of flat pigmented facial lesions and recorded diagnoses and management decisions by experts based on direct clinical examination aided by dermatoscopy including digital dermatoscopic monitoring and by remote experts who reviewed the corresponding confocal images...
February 18, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28209437/the-accuracy-of-preoperative-rigid-stroboscopy-in-the-evaluation-of-voice-disorders-in-children
#15
Jobran Mansour, Ofer Amir, Doron Sagiv, Eran E Alon, Michael Wolf, Adi Primov-Fever
OBJECTIVES: Stroboscopy is considered the most appropriate tool for evaluating the function of the vocal folds but may harbor significant limitations in children. Still, direct laryngoscopy (DL), under general anesthesia, is regarded the "gold standard" for establishing a diagnosis of vocal fold pathology. The aim of the study is to examine the accuracy of preoperative rigid stroboscopy in children with voice disorders. STUDY DESIGN: This is a retrospective study...
February 13, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28201927/histologic-findings-and-cytological-alterations-in-thyroid-nodules-after-radioactive-iodine-treatment-for-graves-disease
#16
Siba El Hussein, Yumna Omarzai
Unlike the well-documented relation between radiation to the neck and development of papillary thyroid carcinoma, a causal association between radioactive iodine treatment for Graves' disease and development of thyroid malignancy is less defined. However, patients with a background of thyroid dysfunction presenting with clinically palpable thyroid nodules are followed more closely than the average population, and fine needle aspiration is recommended in such circumstances. Cytological examination of aspirates, and histologic examination of tissue provided from patients with a known history of Graves' disease, managed by radioactive iodine therapy can create a diagnostic dilemma, as the distinction between radiation effect and a malignant primary thyroid neoplasm can be very challenging...
February 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28201871/targeted-contrast-agent-specific-to-an-oncoprotein-in-tumor-microenvironment-with-the-potential-for-detection-and-risk-stratification-of-prostate-cancer-with-mri
#17
Zheng Han, Yajuan Li, Sarah Roelle, Zhuxian Zhou, Yuchi Liu, Rob Sabatelle, Aidan DeSanto, Xin Yu, Hui Zhu, Cristina Magi-Galluzzi, Zheng-Rong Lu
Accurate detection and risk stratification are paramount to the clinical management of prostate cancer. Current diagnostic methods, including prostate specific antigen (PSA) screening, are unable to differentiate high-risk tumors from low-risk tumors, resulting in overdiagnosis and overtreatment. A peptide targeted contrast agent, ZD2-Gd(HP-DO3A), specific to an oncoprotein in tumor microenvironment, EDB-FN, was synthesized for noninvasive detection and characterization of aggressive prostate cancer. EDB-FN, one of the subtypes of oncofetal fibronectin, is involved in tumor epithelial-to-mesenchymal transition (EMT), which is implicated in drug resistance and metastasis...
March 9, 2017: Bioconjugate Chemistry
https://www.readbyqxmd.com/read/28194522/a-prospective-multi-institutional-validity-study-to-evaluate-the-accuracy-of-clinical-diagnosis-of-pathological-stage-iii-gastric-cancer-jcog1302a
#18
Takeo Fukagawa, Hitoshi Katai, Junki Mizusawa, Kenichi Nakamura, Takeshi Sano, Masanori Terashima, Seiji Ito, Takaki Yoshikawa, Norimasa Fukushima, Yasuyuki Kawachi, Takahiro Kinoshita, Yutaka Kimura, Hiroshi Yabusaki, Yasunori Nishida, Yoshiaki Iwasaki, Sang-Woong Lee, Takashi Yasuda, Mitsuru Sasako
BACKGROUND: Neoadjuvant chemotherapy (NAC) followed by radical surgery is a promising strategy to improve survival of patients with stage III gastric cancer, but is associated with the risk of preoperative overdiagnosis by which patients with early disease may receive unnecessary intensive chemotherapy. METHODS: We assessed the validity of a preoperative diagnostic criterion in a prospective multicenter study. Patients with gastric cancer with a clinical diagnosis of T2/T3/T4, M0, except for diffuse large tumors and extensive bulky nodal disease, were eligible...
February 13, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28191370/overestimating-overdiagnosis-in-breast-cancer-screening
#19
EDITORIAL
Alan Hollingsworth
Overdiagnosis in breast cancer has been a focus of increasing concern with wide ranges of calculations made indirectly through the study of prospective randomized trials and analyses of large registries. While most admit that some degree of overdiagnosis is inherent with ductal carcinoma in situ (DCIS), the rate of overdiagnosis with invasive disease is highly controversial. Although it is generally accepted that overdiagnosis is calculated through indirect means and deductive reasoning, this is not entirely the case...
January 9, 2017: Curēus
https://www.readbyqxmd.com/read/28191285/autoantibodies-against-oncogenic-erg-protein-in-prostate-cancer-potential-use-in-diagnosis-and-prognosis-in-a-panel-with-c-myc-amacr-and-herv-k-gag
#20
Anshu Rastogi, Amina Ali, Shyh-Han Tan, Sreedatta Banerjee, Yongmei Chen, Jennifer Cullen, Charles P Xavier, Ahmed A Mohamed, Lakshmi Ravindranath, Jigisha Srivastav, Denise Young, Isabell A Sesterhenn, Jacob Kagan, Sudhir Srivastava, David G McLeod, Inger L Rosner, Gyorgy Petrovics, Albert Dobi, Shiv Srivastava, Alagarsamy Srinivasan
Overdiagnosis and overtreatment of prostate cancer (CaP) is attributable to widespread reliance on PSA screening in the US. This has prompted us and others to search for improved biomarkers for CaP, to facilitate early detection and disease stratification. In this regard, autoantibodies (AAbs) against tumor antigens could serve as potential candidates for diagnosis and prognosis of CaP. Towards this, our goals were: i) To investigate whether AAbs against ERG oncoprotein (overexpressed in 25-50% of Caucasian American and African American CaP) are present in the sera of CaP patients; ii) To evaluate an AAb panel to enhance CaP detection...
November 2016: Genes & Cancer
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