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"Over diagnosis" OR overdiagnosis

Adam Stenman, Jan Zedenius, Carl Christofer Juhlin
PURPOSE: Pheochromocytomas (PCCs) exhibit malignant potential, but current histological modalities for the proper detection of aggressive behavior are debated. The two most widespread algorithms are the "Pheochromocytoma of the Adrenal Gland Scaled Score" (PASS) and the "Grading System for Adrenal Pheochromocytoma and Paraganglioma" (GAPP), both which mostly rely on histological parameters to identify PCC patients at risk of disseminated disease. Since the algorithms are derived from studies using predominantly sporadic PCCs, little is known whether the PASS or GAPP scores can predict malignant potential in hereditary cases...
May 19, 2018: Langenbeck's Archives of Surgery
L Daines, S McLean, A Buelo, S Lewis, A Sheikh, H Pinnock
Substantial over-diagnosis and under-diagnosis of asthma in adults and children has recently been reported. As asthma is mostly diagnosed in non-specialist settings, a clinical prediction model (CPM) to aid the diagnosis of asthma in primary care may help improve diagnostic accuracy. We aim to systematically identify, describe, compare, and synthesise existing CPMs designed to support the diagnosis of asthma in children and adults presenting with symptoms suggestive of the disease, in primary care settings or equivalent populations...
May 18, 2018: NPJ Primary Care Respiratory Medicine
Sundaram Challa, Saumya Jakati, Megha S Uppin, Meena A Kannan, Rajasekhar Liza, M K Murthy Jagarlapudi
Background: Bohan and Peter criteria are widely used for the diagnosis of idiopathic inflammatory myopathies (IIMs). Recently, European Neuromuscular Center (ENMC) formulated criteria to identify subgroups of IIMs. Aim: To compare the two diagnostic criteria in adult IIMs. Materials and Methods: This was a retrospective review of case records of histologically confirmed IIMs in adults between January 2014 and May 2015. Both the Bohan and Peter, and ENMC 2004 criteria were applied in the same group of patients to subgroup the IIMs...
May 2018: Neurology India
Lenora Marcellus
Health care systems are challenged with issues of overdiagnosis and overtreatment. Neonatal abstinence syndrome (NAS) may be overdiagnosed with standardized assessment protocols and may be overtreated with current NICU-based models of care. Clinical approaches to caring for neonates with NAS and their families have not significantly changed for 40 years, and there is growing interest in revisiting long-standing routine practices. I used Bronfenbrenner's social ecological systems framework to organize an exploration of factors that contribute to overdiagnosis and overtreatment in the care of neonates with NAS...
May 12, 2018: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
I Doña, J C Caubet, K Brockow, M Doyle, E Moreno, I Terreehorst, M J Torres
Adverse drug reactions include drug hypersensitivity reactions (DHRs), which can be immunologically mediated (allergy) or non-immunologically mediated. The high number of DHRs that are unconfirmed and often self-reported is a frequent problem in daily clinical practice, with considerable impact on future prescription choices and patient health. It is important to distinguish between hypersensitivity and non-hypersensitivity reactions by adopting a structured diagnostic approach to confirm or discard the suspected drug, not only to avoid life-threatening reactions, but also to reduce the frequent over-diagnosis of DHRs...
2018: Clinical and Translational Allergy
Shawn D Aaron, Louis Philippe Boulet, Helen K Reddel, Andrea Gershon
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. In the United States 7.6% of adults and 8.4% of children self-report a physician diagnosis of current asthma. Population-based studies in children, adults and the elderly suggest that from 20% to 70% of asthmatics in the community remain undiagnosed and hence untreated. Under-diagnosis of asthma has been found to be associated with under-reporting of respiratory symptoms by patients to their physicians as well as poor socio-economic status...
May 14, 2018: American Journal of Respiratory and Critical Care Medicine
Sujith Ramachandran, Erin R Holmes, Meagen Rosenthal, Benjamin F Banahan, John Young, John P Bentley
The objective of this study was to develop a subtle self-report scale-the Subtle ADHD Malingering Screener (SAMS)-to screen for malingering among individuals reporting symptoms of attention deficit/hyperactivity disorder (ADHD). This study employed a cross-sectional experimental design with an ADHD group, a control group-comprising individuals without ADHD-and a malingering group-comprising individuals without ADHD who were instructed to feign ADHD in their responses. Factor analysis and psychometric testing were conducted to develop a final scale that could distinguish the malingering from the other groups...
May 1, 2018: Assessment
Ivan J Stojanov, Adrian Mariño-Enriquez, Nacef Bahri, Vickie Y Jo, Sook-Bin Woo
Traumatized lipomas with degenerative change may demonstrate histopathologic features that mimic atypical lipomatous tumor (ALT). Previously reported series of ALT involving the oral cavity preceded routine use of MDM2 and CDK4 immunohistochemistry. Our aim is to evaluate MDM2 and CDK4 immunohistochemical expression in adipocytic tumors arising in this site, in conjunction with the histiocytic marker PU.1, to determine whether MDM2 and CDK4 impacts classification. 17 cases originally diagnosed as ALT were retrieved and immunohistochemical studies for MDM2, CDK4 and PU...
May 10, 2018: Head and Neck Pathology
Sian Taylor-Phillips, Chris Stinton, Lavinia Ferrante di Ruffano, Farah Seedat, Aileen Clarke, Jonathan J Deeks
OBJECTIVE: To understand whether international differences in recommendations of whether to screen for rare diseases using the newborn blood spot test might in part be explained by use of systematic review methods. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Website searches of 26 national screening organisations. ELIGIBILITY CRITERIA FOR STUDY SELECTION: Journal articles, papers, legal documents, presentations, conference abstracts, or reports relating to a national recommendation on whether to screen for any condition using the newborn blood spot test, with no restrictions on date or language...
May 9, 2018: BMJ: British Medical Journal
Abel Eduardo Alves, José Manuel Pereira
The concept of ventilator-associated tracheobronchitis is controversial; its definition is not unanimously accepted and often overlaps with ventilator-associated pneumonia. Ventilator-associated tracheobronchitis has an incidence similar to that of ventilator-associated pneumonia, with a high prevalence of isolated multiresistant agents, resulting in an increase in the time of mechanical ventilation and hospitalization but without an impact on mortality. The performance of quantitative cultures may allow better diagnostic definition of tracheobronchitis associated with mechanical ventilation, possibly avoiding the overdiagnosis of this condition...
March 2018: Revista Brasileira de Terapia Intensiva
Arif A Shaukat
[No Abstract Available].
May 2018: Saudi Medical Journal
Hugh S Taylor, G David Adamson, Michael P Diamond, Steven R Goldstein, Andrew W Horne, Stacey A Missmer, Michael C Snabes, Eric Surrey, Robert N Taylor
Challenges intrinsic to the accurate diagnosis of endometriosis contribute to an extended delay between the onset of symptoms and clinical confirmation. Intraoperative visualization, preferably with histologic verification, is considered by many professional organizations to be the gold standard by which endometriosis is diagnosed. Clinical diagnosis of symptomatic endometriosis via patient history, physical examination, and noninvasive tests is easy to perform but generally viewed as less accurate than surgical diagnosis...
May 5, 2018: International Journal of Gynaecology and Obstetrics
Kenneth Elder, Carolyn Nickson, Melinda Pattanasri, Samuel Cooke, Dorothy Machalek, Allison Rose, Arlene Mou, John Paxton Collins, Allan Park, Richard De Boer, Claire Phillips, Vicki Pridmore, Helen Farrugia, G Bruce Mann
BACKGROUND: While population mammographic screening identifies early-stage breast cancers (ESBCs; ductal carcinoma in situ [DCIS] and invasive disease stages 1-3A), commentaries suggest that harms from overdiagnosis and overtreatment may outweigh the benefits. Apparent benefits to patients with screen-detected cancers may be due to selection bias from exclusion of interval cancers (ICs). Treatment intensity is rarely discussed, with an assumption that all ESBCs are treated similarly. We hypothesized that women diagnosed while in a screening program would receive less-intense treatment than those never or not recently screened (NRS)...
May 1, 2018: Annals of Surgical Oncology
Luke Witherspoon, Johnathan L Lau, Rodney H Breau, Christopher Knee, Michael Fung Kee Fung, Robin Morash, Ranjeeta Mallick, Ilias Cagiannos, Christopher Morash, Luke T Lavallée
BACKGROUND: Canadian guidelines recommend against population-based screening for prostate cancer because of the risk of overdiagnosis and overtreatment. We sought to assess whether a higher proportion of patients receiving surgery had clinically significant cancer over time. METHODS: All hospitals in Eastern Ontario that perform prostatectomy participate in a Prostate Cancer Community of Practice, which prospectively maintains a database for the region. Using these data, we conducted a retrospective cohort study that included all patients who underwent prostatectomy from 2009 to 2015 in the region...
April 30, 2018: CMAJ Open
Aaron T Seaman, Kimberly Dukes, Richard M Hoffman, Alan J Christensen, Nicholas Kendell, Andrew L Sussman, Miriam Veléz-Bermúdez, Robert J Volk, Nitin A Pagedar
OBJECTIVE: Shared decision making (SDM) is recommended when offering lung cancer screening (LCS)-which presents challenges with tobacco-related cancer survivors because they were excluded from clinical trials. Our objective was to characterize head and neck cancer (HNC) survivors' knowledge, attitudes, and beliefs toward LCS and SDM. METHODS: Between November 2017 and June 2018, we conducted semi-structured qualitative interviews with 19 HNC survivors, focusing on patients' cancer and smoking history, receptivity to and perceptions of LCS, and decision-making preferences RESULTS: Participants were receptive to LCS, referencing their successful HNC outcomes...
April 22, 2018: Patient Education and Counseling
Jerome M Reich, Jong S Kim
No abstract text is available yet for this article.
March 2018: Journal of Thoracic Disease
Eric R Coon, H Gilbert Welch
No abstract text is available yet for this article.
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Victoria Mango, Yolanda Bryce, Elizabeth Anne Morris, Elisabetta Gianotti, Katja Pinker
Screening mammography reduces breast cancer mortality in average-risk women. However, adverse consequences include false-positive findings possibly leading to benign breast biopsies and patient anxiety. There is also potential for overdiagnosis and overtreatment. Differences in how to balance benefits and harms have led to varying recommendations by the U.S. Preventive Services Task Force, the American Cancer Society, the National Comprehensive Cancer Network and the American College of Radiology/Society of Breast Imaging...
April 24, 2018: British Journal of Radiology
M J Díaz Candamio, S Jha, J Martel Villagrán
Overdiagnosis, more than an error regarding the diagnosis, is an error regarding the prognosis. We cannot know what consequences some lesions that we detect by imaging would have on our patients' lives if they were left untreated. As long as it is not possible for imaging techniques to differentiate between lesions that will have an indolent course from those that will have an aggressive course, there will be overdiagnosis. Advanced imaging techniques, radiomics, and radiogenomics, together with artificial intelligence, promise advances in this sense...
April 20, 2018: Radiología
Seri Hong, Suyeon Kim, Mina Suh, Boyoung Park, Kui Son Choi, Jae Kwan Jun
OBJECTIVES: Through a survey on perception of lung cancer screening and accompanying medical radiation exposure in Korea, the present study was to investigate its current situations and evaluate various perception of physicians regarding it in order to propose measures for improvements. METHODS: Medical specialists in national cancer screening institutions selected through stratified random sampling were subjected to face-to-face interview using a structured questionnaire...
2018: Epidemiology and Health
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