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"Over diagnosis" OR overdiagnosis

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https://www.readbyqxmd.com/read/28930171/comprehensive-evaluation-of-tff3-promoter-hypomethylation-and-molecular-biomarker-potential-for-prostate-cancer-diagnosis-and-prognosis
#1
Maibritt Nørgaard, Christa Haldrup, Tine Maj Storebjerg, Else Marie Vestergaard, Peter J Wild, Søren Høyer, Michael Borre, Torben Falck Ørntoft, Karina Dalsgaard Sørensen
Overdiagnosis and overtreatment of clinically insignificant tumors remains a major problem in prostate cancer (PC) due to suboptimal diagnostic and prognostic tools. Thus, novel biomarkers are urgently needed. In this study, we investigated the biomarker potential of Trefoil factor 3 (TFF3) promoter methylation and RNA expression levels for PC. Initially, by quantitative methylation specific PCR (qMSP) analysis of a large radical prostatectomy (RP) cohort (n = 292), we found that the TFF3 promoter was significantly hypomethylated in PC compared to non-malignant (NM) prostate tissue samples (p < 0...
September 20, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28925663/top-poems-of-2016-consistent-with-the-principles-of-the-choosing-wisely-campaign
#2
Roland Grad, Mark H Ebell
A challenge in the Choosing Wisely campaign is to identify low-value clinical actions supported by high-quality evidence. We applied a method based on crowdsourcing the Daily POEM (patient-oriented evidence that matters) to identify low-value clinical actions from research studies consistent with the principles of Choosing Wisely. In 2016, we analyzed an average of 1,382 questionnaires on 265 unique POEMs delivered to physician members of the Canadian Medical Association. From these questionnaires, we identified the POEMs ranking highest on one questionnaire item directly linked to reducing overdiagnosis or overtreatment...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28924688/the-barrier-to-informed-choice-in-cancer-screening-statistical-illiteracy-in-physicians-and-patients
#3
Odette Wegwarth, Gerd Gigerenzer
An efficient health care requires both informed doctors and patients. Our current healthcare system falls short on both counts. Most doctors and patients do not understand the available medical evidence. To illustrate the extent of the problem in the setting of cancer screening: In a representative sample of some 5000 women in nine European countries, 92% overestimated the reduction of breast cancer mortality by mammography by a factor of 10-200, or did not know. For a similar sample of about 5000 men with respect to PSA screening, this number was 89%...
2018: Recent Results in Cancer Research
https://www.readbyqxmd.com/read/28918559/prostate-cancer-screening-by-prostate-specific-antigen-psa-a-relevant-approach-for-the-small-population-of-the-cayman-islands
#4
Shravana Kumar Jyoti, Camille Blacke, Pallavi Patil, Vibha P Amblihalli, Amanda Nicholson
INTRODUCTION: The common tool for diagnosing prostate cancer is prostate-specific antigen (PSA), but the high sensitivity and low specificity of PSA testing are the problems in clinical practice. There are no proper guidelines to investigate the suspected prostate cancer in the Cayman Islands. We correlated PSA levels with the incidence of prostate cancers by tissue diagnosis and proposed logical protocol for prostate screening by using PSA test in this small population. MATERIALS AND METHODS: A total of 165 Afro Caribbean individuals who had prostate biopsy done after the investigations for PSA levels from year 2005 to 2015 were studied retrospectively...
September 16, 2017: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/28917266/urinary-biomarkers-in-prostate-cancer-detection-and-monitoring-progression
#5
REVIEW
Duojia Wu, Jie Ni, Julia Beretov, Paul Cozzi, Mark Willcox, Valerie Wasinger, Bradley Walsh, Peter Graham, Yong Li
Prostate cancer (CaP) is the most common cancer in men and the second leading cause of cancer deaths in males in Australia. Although serum prostate-specific antigen (PSA) has been the most widely used biomarker in CaP detection for decades, PSA screening has limitations such as low specificity and potential association with over-diagnosis. Current biomarkers used in the clinic are not useful for the early detection of CaP, or monitoring its progression, and have limited value in predicting response to treatment...
October 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28914565/reducing-overdiagnosis-in-primary-care-is-needed
#6
Carl Llor
No abstract text is available yet for this article.
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/28901600/ethical-issues-raised-by-thyroid-cancer-overdiagnosis-a-matter-for-public-health
#7
Wendy A Rogers, Wendy L Craig, Vikki A Entwistle
Current practices of identifying and treating small indolent thyroid cancers constitute an important but in some ways unusual form of overdiagnosis. Overdiagnosis refers to diagnoses that generally harm rather than benefit patients, primarily because the diagnosed condition is not a harmful form of disease. Patients who are overdiagnosed with thyroid cancer are harmed by the psycho-social impact of a cancer diagnosis, as well as treatment interventions such partial or total thyroidectomy, lifelong thyroid replacement hormone, monitoring, surgical complications and other side effects...
October 2017: Bioethics
https://www.readbyqxmd.com/read/28900493/a-multi-center-prospective-study-to-validate-an-algorithm-using-urine-and-plasma-biomarkers-for-predicting-gleason-%C3%A2-3-4-prostate-cancer-on-biopsy
#8
Maher Albitar, Wanlong Ma, Lars Lund, Babak Shahbaba, Edward Uchio, Soren Feddersen, Donald Moylan, Kirk Wojno, Neal Shore
Background: Unnecessary biopsies and overdiagnosis of prostate cancer (PCa) remain a serious healthcare problem. We have previously shown that urine- and plasma-based prostate-specific biomarkers when combined can predict high grade prostate cancer (PCa). To further validate this test, we performed a prospective multicenter study recruiting patients from community-based practices. Patients and Methods: Urine and plasma samples from 2528 men were tested prospectively. Results were correlated with biopsy findings, if a biopsy was performed as deemed necessary by the practicing urologist...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28899412/the-effect-of-information-about-the-benefits-and-harms-of-mammography-on-women-s-decision-making-study-protocol-for-a-randomized-controlled-trial
#9
Misericòrdia Carles, Montserrat Martínez-Alonso, Anna Pons, Maria José Pérez-Lacasta, Lilisbeth Perestelo-Pérez, Maria Sala, Carmen Vidal, Montse Garcia, Ana Toledo-Chávarri, Núria Codern, Maria Feijoo-Cid, Anabel Romero, Roger Pla, Jorge Soler-González, Xavier Castells, Montserrat Rué
BACKGROUND: The decision to participate or not in breast cancer screening is complex due to the trade-off between the expected benefit of breast cancer mortality reduction and the major harm of overdiagnosis. It seems ethically necessary to inform women so that they can actively participate in decision-making and make an informed choice based on their values and preferences. The objective of this study is to assess the effects of receiving information about the benefits and harms of screening on decision-making, in women approaching the age of invitation to mammography screening...
September 12, 2017: Trials
https://www.readbyqxmd.com/read/28898991/defining-papillary-carcinoma-of-the-thyroid-a-short-review-and-analysis
#10
Robin T Vollmer
Objectives: To review how changes in the pathologic definitions for papillary tumors of the thyroid during recent decades have affected outcomes for patients with these tumors. Methods: Forty-nine previous reports or studies involving collectively 53,606 patients were reviewed, and new analyses were performed on the data to include analyses of agreement, incidence, survival, and diagnostic categories. Results: The past emphasis on cytologic features to define papillary tumors has not resulted in ideal pairwise agreement between pathologists and has produced incidence and survival data suggesting overdetection and overdiagnosis...
August 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28894698/paradigm-shift-toward-reducing-overtreatment-of-ductal-carcinoma-in-situ-of-breast
#11
REVIEW
Yasuaki Sagara, Wong Julia, Mehra Golshan, Masakazu Toi
The prevalence of ductal carcinoma in situ (DCIS) of the breast has increased substantially after the introduction of breast cancer screening programs, although the clinical effects of early DCIS detection and treatment remain unclear. The standard treatment for DCIS has involved local breast-conserving surgery (BCS) followed by radiotherapy (RT) or total mastectomy with/without endocrine therapy, and the choice of local treatment is not usually based on clinicopathologic or biological factors. However, we have investigated the effectiveness of local treatment using breast surgery and RT using Surveillance, Epidemiology, and End Results data, and found that the effectiveness of breast surgery was modified by the nuclear grade...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28893765/requirement-for-cystatin-c-testing-in-chronic-kidney-disease-a-retrospective-population-based-study
#12
Daniel S Lasserson, Brian Shine, Christopher A O'Callaghan, Tim James
BACKGROUND: Creatinine-based estimated glomerular filtration rate (eGFR) determines chronic kidney disease (CKD) stage, but underestimates renal function. The 2014 updated guidance from the National Institute for Health and Care Excellence (NICE) recommends that GPs reduce overdiagnosis of CKD stage 3a (eGFR 45-60 ml/min/1.73 m(2)) by using the renal biomarker cystatin C. AIM: To determine the population requirement for cystatin C testing, compared with current national availability of the assay...
September 11, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28884617/strengths-and-gaps-in-physicians-risk-communication-a-scenario-study-of-the-influence-of-numeracy-on-cancer-screening-communication
#13
Dafina Petrova, Olga Kostopoulou, Brendan C Delaney, Edward T Cokely, Rocio Garcia-Retamero
OBJECTIVE: Many patients have low numeracy, which impedes their understanding of important information about health (e.g., benefits and harms of screening). We investigated whether physicians adapt their risk communication to accommodate the needs of patients with low numeracy, and how physicians' own numeracy influences their understanding and communication of screening statistics. METHODS: UK family physicians ( N = 151) read a description of a patient seeking advice on cancer screening...
September 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28866466/impact-of-clinical-guidelines-on-voiding-cystourethrogram-utilization-and-vesicoureteral-reflux-incidence
#14
Ted Lee, Chandy Ellimoottil, Kathryn A Marchetti, Tanima Banerjee, Vesna Ivančić, Kate H Kraft, David A Bloom, John M Park, Julian Wan
BACKGROUND: To prevent overdiagnosis and overtreatment of vesicoureteral reflux, the 2007 British National Institution of Clinical Excellence (NICE) and 2011 American Academy of Pediatrics (AAP) guidelines both recommended against routine voiding cystourethrogram in children presenting with first febrile urinary tract infections. The impact of these guidelines on clinical practice is unknown. METHODS: Using an administrative claims database (Cliniformatics(TM) Data Mart), children with voiding cystourethrogram or diagnosis of vesicoureteral reflux between 2001 and 2015 were identified...
August 30, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28863965/-utility-of-normality-low-limit-of-spirometry-in-diagnosed-copd-patients
#15
J C Naveiro-Rilo, S García García, L Flores-Zurutuza, L Carazo Fernández, C Domínguez Fernández, J L Palomo García
AIM: To evaluate the differences in COPD patients below the lower limit of normal (LLN) of the fixed ratio FEV1/FVC < 0.70 and those above this limit. PATIENTS AND METHODS: Cross-sectional study. COPD patients between 40 and 85 years old included in primary care clinical record database were randomly selected. Baseline and postbronchodilator spirometries were performed. Two groups of patients were established: FEV1/FVC<0.70 and ≤LIN (group1) and FEV/FVC<0...
August 29, 2017: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/28860736/overdiagnosis-of-copd-in-hospitalized-patients
#16
Kerry Spero, Ghiath Bayasi, Linda Beaudry, Kimberly R Barber, Fahim Khorfan
BACKGROUND: The diagnosis of chronic obstructive pulmonary disease (COPD) is usually made based on history and physical exam alone. Symptoms of dyspnea, cough, and wheeze are nonspecific and attributable to a variety of diseases. Confirmatory testing to verify the airflow obstruction is available but rarely used, which may result in substantial misdiagnoses of COPD. The aim of this study is to evaluate the use of confirmatory testing and assess the accuracy of the diagnosis. METHODS: From January 2011 through December 2013, 6,018 patients with COPD as a principal or leading diagnosis were admitted at a community teaching hospital...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28857962/women-s-awareness-of-and-responses-to-messages-about-breast-cancer-overdiagnosis-and-overtreatment-results-from-a-2016-national-survey
#17
Rebekah H Nagler, Erika Franklin Fowler, Sarah E Gollust
BACKGROUND: Scientists, clinicians, and other experts aim to maximize the benefits of cancer screening while minimizing its harms. Chief among these harms are overdiagnosis and overtreatment. Although available data suggest that patient awareness of these harms is low, we know little about how patients respond to information about these phenomena. OBJECTIVES: Using the case of breast cancer screening, this study assesses women's awareness of and reactions to statements about overdiagnosis and overtreatment...
August 28, 2017: Medical Care
https://www.readbyqxmd.com/read/28853167/a-urinary-biomarker-based-risk-score-correlates-with-multiparametric-mri-for-prostate-cancer-detection
#18
Rianne J Hendriks, Marloes M G van der Leest, Siebren Dijkstra, Jelle O Barentsz, Wim Van Criekinge, Christina A Hulsbergen-van de Kaa, Jack A Schalken, Peter F A Mulders, Inge M van Oort
BACKGROUND: Prostate cancer (PCa) diagnostics would greatly benefit from more accurate, non-invasive techniques for the detection of clinically significant disease, leading to a reduction of over-diagnosis and over-treatment. The aim of this study was to determine the association between a novel urinary biomarker-based risk score (SelectMDx), multiparametric MRI (mpMRI) outcomes, and biopsy results for PCa detection. METHODS: This retrospective observational study used data from the validation study of the SelectMDx score, in which urine was collected after digital rectal examination from men undergoing prostate biopsies...
August 29, 2017: Prostate
https://www.readbyqxmd.com/read/28843825/implementation-of-a-rapid-hit-immunoassay-at-a-university-hospital-retrospective-analysis-of-hit-laboratory-orders-in-patients-with-thrombocytopenia
#19
Anne Black, Susanne Heimerl, Linnéa Oertli, Wolf Wilczek, Andreas Greinacher, Michael Spannagl, Wolfgang Herr, Christina Hart
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a rare cause of thrombocytopenia and a potentially life-threatening adverse drug reaction. Clinical overdiagnosis of HIT results in costly laboratory tests and anticoagulation. Criteria and algorithms for diagnosis are established, but their translation into clinical practice is still challenging. STUDY DESIGN AND METHODS: In a retrospective approach we studied all HIT related laboratory test requests within four years and evaluated data before (1st period, 24month) and after (2nd period, 24month) replacing particle gel immunoassay (PaGIA) and enzyme-linked immunosorbent assay (ELISA) by a chemiluminescent immunoassay (CLIA)...
August 15, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28838313/trade-off-between-benefits-harms-and-economic-efficiency-of-low-dose-ct-lung-cancer-screening-a-microsimulation-analysis-of-nodule-management-strategies-in-a-population-based-setting
#20
Marina Treskova, Ines Aumann, Heiko Golpon, Jens Vogel-Claussen, Tobias Welte, Alexander Kuhlmann
BACKGROUND: In lung cancer screening, a nodule management protocol describes nodule assessment and thresholds for nodule size and growth rate to identify patients who require immediate diagnostic evaluation or additional imaging exams. The Netherlands-Leuvens Screening Trial and the National Lung Screening Trial used different selection criteria and nodule management protocols. Several modelling studies have reported variations in screening outcomes and cost-effectiveness across selection criteria and screening intervals; however, the effect of variations in the nodule management protocol remains uncertain...
August 25, 2017: BMC Medicine
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