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"Over diagnosis" OR overdiagnosis

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https://www.readbyqxmd.com/read/28624014/can-routine-chest-radiography-be-used-to-diagnose-mild-copd-a-nested-case-control-study
#1
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/28622797/making-the-best-value-of-clinical-radiology-irefer-guidelines-8th-edition
#2
D Remedios, B France, M Alexander
New uses of medical imaging as well as over-diagnosis and wasteful imaging have led to a 10% per annum growth in computed tomography (CT) and magnetic resonance imaging (MRI). Personalised value to the patient will be helped by referral guidelines for the best test first, adding evidence-based technical value to the investigation to answer the clinical question, thus providing allocative value to the commissioners of medical imaging. Appropriate imaging is driven by the need for effective decisions, radiation safety, and cost awareness...
June 13, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28619546/screening-in-developmental-dysplasia-of-the-hip-ddh
#3
REVIEW
Robin W Paton
Screening for Developmental Dysplasia of the Hip (DDH) is a controversial subject. Screening may be by universal neonatal clinical examination (Ortolani or Barlow manoeuvres) with the addition of sonographic imaging of the hip (selective 'at risk' hips or universal screening in the neonate). In the UK, the NIPE guidelines recommend universal neonatal clinical assessment of the hip joints, a General Practitioner 6-8 week clinical 'hip check' and assessment clinically with sonographic imaging at 4-6 weeks for certain 'at risk' hips for pathological DDH...
June 12, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28617483/epidemiology-of-chronic-kidney-disease-think-at-least-twice
#4
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
#5
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
#6
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
#7
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/28612287/methylation-markers-differentiate-thyroid-cancer-from-benign-nodules
#8
J K Stephen, K M Chen, J Merritt, D Chitale, G Divine, M J Worsham
PURPOSE: The incidence of thyroid cancer (TC) is increasing. Cytology by itself cannot distinguish TC from some benign nodules especially in certain subtypes of TC. Our immediate goal is to identify DNA methylation markers for early detection of TC and to molecularly differentiate TC subtypes from benign nodules. METHODS: Promoter methylation status of 21 candidate genes was examined on formalin-fixed paraffin-embedded tissue (FFPE) utilizing quantitative methylation-specific polymerase chain reaction (QMSP) in a retrospective cohort of 329 patients (56% white, 29% African American, 61% female) comprising 71 normal thyroid, 83 benign nodules [follicular adenomas (FA)], 90 follicular TC (FTC) and 85 papillary TC (PTC)...
June 13, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28607597/psa-and-prostate-health-index-based-prostate-cancer-screening-in-a-hereditary-migration-complicated-population-implications-in-precision-diagnosis
#9
Mariyam Akizhanova, Elzira E Iskakova, Valdemir Kim, Xiao Wang, Roman Kogay, Aiym Turebayeva, Qinglei Sun, Ting Zheng, Shenghui Wu, Lixia Miao, Yingqiu Xie
Precision diagnosis requires specific markers for differential ethnic populations. Prostate-Specific Antigen (PSA) level (threshold of 4ng/ml) has been widely used to screen prostate cancer and as reference of pro-biopsy but false diagnosis frequently occurs. Prostate health Index (PHI) is a new diagnosis marker which combines PSA, free PSA and p2PSA4. Overall the PCa screening database is lacking in Kazakhstani patients. We analyzed the PSA levels and Gleason scores of 222 biopsies collected in 2015 in Almaty area, Kazakhstan approved by institutional ethics board...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28595914/ischemia-induced-glomerular-parietal-epithelial-cells-hyperplasia-commonly-misdiagnosed-cellular-crescent-in-renal-biopsy
#10
Yeting Zeng, Xinrui Wang, Feilai Xie, Zhiyong Zheng
Ischemic pseudo-cellular crescent (IPCC) that is induced by ischemia and composed of hyperplastic glomerular parietal epithelial cells resembles cellular crescent. In this study, we aimed to assess the clinical and pathological features of IPCC in renal biopsy to avoid over-diagnosis and to determine the diagnostic basis. 4 IPCC cases diagnosed over a 4-year period (2012-2015) were evaluated for the study. Meanwhile, 5 cases of ANCA-associated glomerulonephritis and 5 cases of lupus nephritis (LN) were selected as control...
April 20, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28594049/venous-thromboembolism-past-present-and-future
#11
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
#12
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/28591506/-persists-the-controversy-concerning-the-rutinary-use-of-diagnostic-tests-in-asymptomatic-persons
#13
Arturo Zárate, Marcelino Hernández-Valencia, Lourdes Basurto, Renata Saucedo
Currently, in medicine there is an environment replete with controversy and debate, partially due to the popular concept Evidence-Based Medicine, and to the development of technological advances and, apparently, better therapeutic resources. This has led to the establishment of an over-diagnosis epidemic and to an excess of therapeutic interventions, which do not necessarily lead to a longer life expectancy. Some medical controversies, which have called the attention of physicians and even of common people are those related with dislipoproteinemias, pre-diabetes and detection of cancer in asymptomatic persons...
July 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28589223/erratum-to-risk-of-over-diagnosis-of-hypotension-in-children-a-comparative-analysis-of-over-50-000-blood-pressure-measurements
#14
Samiran Ray, Libby Rogers, David P Noren, Ranjana Dhar, Simon Nadel, Mark J Peters, David P Inwald
No abstract text is available yet for this article.
June 6, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28587433/statsensor-i-point-of-care-creatinine-analyzer-may-identify-patients-at-high-risk-of-contrast-induced-nephropathy
#15
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
#16
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
#17
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/28576535/adherence-to-acute-otitis-media-diagnosis-and-treatment-guidelines-among-israeli-otolaryngologists
#18
Tal Marom, Mathan Bobrow, Ephraim Eviatar, Yahav Oron, Sharon Ovnat Tamir
INTRODUCTION: The recent Israeli acute otitis media (AOM) guidelines, drafted mainly by pediatricians and family physicians in 2013, addressed diagnostic and therapeutic issues, in order to reduce over-diagnosis and treatment. These guidelines are considered as the 'standard of care' for AOM management. While the adherence rate of pediatricians to previous Israeli AOM guidelines (2004) was reported to be high (>85%), the compliance of otolaryngologists has not been studied. METHODS: An anonymous 19-item questionnaire was circulated among practicing Israeli otolaryngologists (residents [n = 93], specialists [n = 283])...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28557900/controversies-in-venous-thromboembolism
#19
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
#20
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
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