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"Over diagnosis" OR overdiagnosis

M J J Kunst, M Van de Wiel
The current study investigated whether mental health practitioners are influenced by the narrative fallacy when assessing the psychological injuries of trauma victims. The narrative fallacy is associated with our tendency to establish logical links between different facts. In psychodiagnostic assessments, this tendency may result in overdiagnosis of mental disorders when psychological symptoms can be attributed to a traumatic event. Consequently, legal decision makers may be at risk of awarding compensation for psychological injuries which are not severe enough to justify financial reimbursement...
2016: Psychological Injury and Law
Hui Zhang, Shucai Zhang
Lung cancer is the leading cause of cancer mortality currently. Early diagnosis is crucial to the good prognosis of lung cancer. Evidence has shown that low-dose computed tomography (CT) screening can make the decline in the mortality of lung cancer. However, there are still many problems in the screening, such as, high false-positive rates, overdiagnosis and radiation exposure. As another non-invasive tumor screening method, blood-based tumor markers showed a high sensitivity and specificity in early diagnosis of lung cancer in recent years...
October 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Dawn S Hughes, Everett F Magann
The evaluation of amniotic fluid volume (AFV) is an established part of the antenatal surveillance of pregnancies at risk for an adverse pregnancy outcome. The two most commonly used ultrasound techniques to estimate AFV are the amniotic fluid index (AFI) and the single deepest pocket (SDP). Four studies have defined normal AFVs, and although their normal volumes have similarities, there are also differences primarily due to the statistical methodology used in each study. Dye-determined AFV correlates with ultrasound estimates for normal fluid volumes but correlates poorly for oligohydramnios and polyhydramnios...
September 16, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
Paula A van Luijt, Eveline Am Heijnsdijk, Nicolien T van Ravesteyn, Solveig Hofvind, Harry J de Koning
OBJECTIVE: Fluctuations in the incidence of breast cancer in Norway in the last three decades are partly explained by the use of hormone replacement therapy and mammography screening, but overdiagnosis has also been suggested as a cause. We assessed the trends in breast cancer incidence and overdiagnosis in Norway. METHODS: We calibrated our microsimulation model to Norwegian Cancer Registration data. The model takes into account the use of mammography (both within and outside the Norwegian Breast Cancer Screening Programme) and of hormone replacement therapy...
October 17, 2016: Journal of Medical Screening
M C Carrera Gómez, M C Estrada Blan
High breast density and its relationship to the risk of breast cancer has become a hot topic in the medical literature and in the lay press, especially in the United States, where it has brought about changes in the legal framework that require radiologists to inform clinicians and patients about breast density. Radiologists, who are mainly responsible for this information, need to know the scientific evidence and controversies regarding this subject. The discussion is centered on the real importance of the risk, the limitation that not having standardized methods of measurement represents, and the possible application of complementary screening techniques (ultrasound, magnetic resonance imaging, or tomosynthesis) for which clear recommendations have yet to be established...
October 14, 2016: Radiología
Michael S Leapman, Peter R Carroll
INTRODUCTION: Selective treatment approaches for prostate cancer (PCa) are warranted given the highly varied nature of the disease and the consequences associated with definitive therapy. MATERIALS AND METHODS: We present a stepwise overview of strategies to not treat PCa, ranging from improved early detection practices that seek to improve the yield at initial diagnosis, as well as refinements to risk prediction and the performance of active surveillance. RESULTS: Adherence to screening guidelines is non-uniform...
October 13, 2016: Urologic Oncology
Stacy Loeb, Sanghyuk S Shin, Dennis L Broyles, John T Wei, Martin Sanda, George Klee, Alan W Partin, Lori Sokoll, Daniel W Chan, Chris H Bangma, Ron H N van Schaik, Kevin M Slawin, Leonard S Marks, William J Catalona
OBJECTIVE: To examine the use of the Prostate Health Index (phi)* as a continuous variable in multivariable risk assessment for aggressive prostate cancer in a large multicenter US study. MATERIALS AND METHODS: The study population included 728 men with PSA levels of 2-10 ng/mL and negative digital rectal examination enrolled in a prospective, multi-site early detection trial. The primary endpoint was aggressive prostate cancer, defined as biopsy Gleason score ≥7...
October 15, 2016: BJU International
Roman Gulati, Heather H Cheng, Paul H Lange, Peter S Nelson, Ruth Etzioni
BACKGROUND: Guidelines for prostate-specific antigen (PSA) screening in subgroups with increased risk of prostate cancer (PCa) diagnosis due to race or genotype are underdeveloped. Our goal was to investigate types of increased PCa risk and implications for targeted screening. METHODS: Computer simulation of subgroups with average and hypothetical increased risk(s) of onset of latent disease, progression, and/or cancer-specific death. For each subgroup, we predicted lifetime probabilities of overdiagnosis and life saved under more and less intensive PSA screening strategies...
October 14, 2016: Cancer Epidemiology, Biomarkers & Prevention
John R Benson, Ismail Jatoi, Masakazu Toi
The heterogeneous nature of ductal carcinoma in situ has been emphasised by data for breast-cancer screening that show substantial increases in the detection of early-stage non-invasive breast cancer but no noteworthy change in the incidence of invasive and distant metastatic disease. Indolent non-progressive forms of ductal carcinoma in situ are managed according to similar surgical strategies as high-risk disease, with extent of resection dictated by radiological and pathological estimates of tumour dimensions...
October 2016: Lancet Oncology
Joann G Elmore
No abstract text is available yet for this article.
October 13, 2016: New England Journal of Medicine
H Gilbert Welch, Philip C Prorok, A James O'Malley, Barnett S Kramer
Background The goal of screening mammography is to detect small malignant tumors before they grow large enough to cause symptoms. Effective screening should therefore lead to the detection of a greater number of small tumors, followed by fewer large tumors over time. Methods We used data from the Surveillance, Epidemiology, and End Results (SEER) program, 1975 through 2012, to calculate the tumor-size distribution and size-specific incidence of breast cancer among women 40 years of age or older. We then calculated the size-specific cancer case fatality rate for two time periods: a baseline period before the implementation of widespread screening mammography (1975 through 1979) and a period encompassing the most recent years for which 10 years of follow-up data were available (2000 through 2002)...
October 13, 2016: New England Journal of Medicine
Shingo Hatakeyama, Tohru Yoneyama, Yuki Tobisawa, Chikara Ohyama
The application of prostate-specific antigen (PSA) in prostate cancer (PC) screening, diagnosis, and prognosis has improved the clinical management of PC patients. However, the PSA assay has been faced with criticism due to its potential association with over-diagnosis and subsequent overtreatment of patients with indolent disease. The United States Preventive Services Task Force incited much debate over PSA-based screening in 2012 by recommending against this approach. However, the PSA assay remains the first-line tool for the early detection of PC...
October 11, 2016: International Journal of Clinical Oncology
Tom Blakeman, Kathryn Griffith, Dan Lasserson, Berenice Lopez, Jung Y Tsang, Stephen Campbell, Charles Tomson
OBJECTIVES: Tackling the harm associated with acute kidney injury (AKI) is a global priority. In England, a national computerised AKI algorithm is being introduced across the National Health Service (NHS) to drive this change. The study sought to maximise its clinical utility and minimise the potential for burden on clinicians and patients in primary care. DESIGN: An appropriateness ratings evaluation using the RAND/UCLA Appropriateness Method. SETTING: Clinical scenarios were developed to test the timeliness in (1) communication of AKI warning stage test results from clinical pathology services to primary care, and (2) primary care clinician response to an AKI warning stage test result...
October 11, 2016: BMJ Open
Karsten Juhl Jørgensen, Mette Kalager, Alexandra Barratt, Cornelia Baines, Per-Henrik Zahl, John Brodersen, Russell P Harris
Updated guidelines on breast cancer screening have been published by several major organisations over the past five years. Recommendations vary regarding both age range, screening interval, and even on whether breast screening should be offered at all. The variation between recommendations reflects substantial differences in estimates of the major benefit (breast cancer mortality reduction) and the major harm (overdiagnosis). Estimates vary considerably among randomised trials, as well as observational studies: from no benefit to large reductions, and from no overdiagnosis to substantial levels...
October 4, 2016: Breast: Official Journal of the European Society of Mastology
Margret Johansson Gudjónsdóttir, Karsten Kötz, Ruth Stangebye Nielsen, Philip Wilmar, Sofia Olausson, Daniel Wallmyr, Birger Trollfors
BACKGROUND: Immigrants from countries with high incidence of tuberculosis (TB) are usually offered screening when they arrive to low incidence countries. The tuberculin skin test (TST) is often used. The interferon gamma release assays (IGRAs) are more specific and not affected by BCG vaccination. The aims of this study were 1. To see if there if there is a correlation between a positive IGRA (QFT) and presence of a BCG scar in children with TST ≥10 mm, 2. To compare the TST diameter with QFT result, 3...
October 6, 2016: BMC Infectious Diseases
Brennen A McKenzie
No abstract text is available yet for this article.
October 15, 2016: Journal of the American Veterinary Medical Association
Paola Portillo-Sanchez, Rene Rodriguez-Gutierrez, Juan P Brito
No abstract text is available yet for this article.
October 3, 2016: JAMA Internal Medicine
Theresa Tawiah, Kristian Schultz Hansen, Frank Baiden, Jane Bruce, Mathilda Tivura, Rupert Delimini, Seeba Amengo-Etego, Daniel Chandramohan, Seth Owusu-Agyei, Jayne Webster
BACKGROUND: The presumptive approach of confirming malaria in health facilities leads to over-diagnosis of malaria, over use of anti-malaria drugs and the risk of drug resistance development. WHO recommends parasitological confirmation before treatment with artemisinin-based combination therapy (ACT) in all suspected malaria patients. The use of malaria rapid diagnostic tests (mRDTs) would make it possible for prescribers to diagnose malaria at point-of-care and better target the use of antimalarials...
2016: PloS One
R Garrastazu, J L García-Rivero, M Ruiz-Nuñez, J M Helguera, S Arenal, C Bonnardeux, C León, M Miravitlles, M Santibañez
INTRODUCTION/OBJECTIVE: One of main limitations in studies of COPD in health databases could be the low quality of the information. Our first aim was evaluate reliability of the registry of COPD diagnosis register in Primary Care. A description and comparison is also presented of the characteristics of the patients according to the diagnostic confirmation. MATERIAL AND METHODS: A cross-sectional study using healthcare databases of Cantabria. A pre-selected sample of 1,457 patients was obtained in which COPD diagnosis was specifically registered...
September 27, 2016: Semergen
Jenna MacNeil, Robyn H Loves, Shawn D Aaron
Asthma is diagnosed based on patients' respiratory symptoms of wheeze, cough, chest tightness and/or dyspnea together with physiologic evidence of variable and reversible expiratory airflow limitation. A high prevalence of overdiagnosis, underdiagnosis and misdiagnosis of adult asthma has been reported in the literature. Areas covered: Misdiagnosis of asthma in adults can occur in the community due to physicians' failure to confirm airflow limitation using spirometry, the relatively poor sensitivity of spirometry to absolutely rule in asthma, the complexity of multiple asthma phenotypes and endotypes, and the inherent day to day variability of asthma symptoms and airflow limitation...
October 8, 2016: Expert Review of Respiratory Medicine
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