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"Over diagnosis" OR overdiagnosis

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https://www.readbyqxmd.com/read/28725581/direct-magnetic-resonance-imaging-guided-biopsy-of-the-prostate-lessons-learned-in-establishing-a-regional-referral-center
#1
REVIEW
Benjamin Addicott, Bryan R Foster, Chenara Johnson, Alice Fung, Christopher L Amling, Fergus V Coakley
MRI-targeted biopsy of the prostate appears to have the potential to reduce the high rates of underdiagnosis and overdiagnosis associated with the current diagnostic standard of transrectal ultrasound guided systematic biopsy. Direct or "in bore" MRI-guided biopsy is one of the three methods for MRI-targeted core needle sampling of suspicious, generally Pi-RADS 4 or 5, foci within the prostate, and our early experience suggests the approach demonstrates substantial utility and promise in the care of patients with prostate cancer...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28725579/multiparametric-magnetic-resonance-imaging-of-the-prostate-a-basic-tutorial
#2
REVIEW
Miguel C Cabarrus, Antonio C Westphalen
Prostate cancer is the second most common cause of cancer related death in the United States and the most commonly diagnosed malignancy in men. In general, prostate cancer is slow growing, though there is a broad spectrum of disease that may be indolent, or aggressive and rapidly progressive. Screening for prostate is controversial and complicated by lack of specificity and over diagnosis of clinically insignificant cancer. Imaging has played a role in diagnosis of prostate cancer, primarily through systemic transrectal ultrasound (TRUS) guided biopsy...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28723298/given-overdiagnosis-recall-reduction-should-trump-dcis-detection
#3
John D Keen, Karsten J Jørgensen
No abstract text is available yet for this article.
August 2017: Radiology
https://www.readbyqxmd.com/read/28719430/high-sensitivity-cardiac-troponin-t-improves-the-diagnosis-of-perioperative-mi
#4
Jamie C Brown, Eslam Samaha, Srikar Rao, Mohammad A Helwani, Andreas Duma, Frank Brown, Brian F Gage, J Philip Miller, Allan S Jaffe, Fred S Apple, Mitchell G Scott, Peter Nagele
BACKGROUND: The diagnosis of myocardial infarction (MI) after noncardiac surgery has traditionally relied on using relatively insensitive contemporary cardiac troponin (cTn) assays. We hypothesized that using a recently introduced novel high-sensitivity cTnT (hscTnT) assay would increase the detection rate of perioperative MI. METHODS: In this ancillary study of the Vitamins in Nitrous Oxide trial, readjudicated incidence rates of myocardial injury (new isolated cTn elevation) and MI were compared when diagnosed by contemporary cTnI versus hscTnT...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28713442/overdiagnosis-an-unrecognised-and-growing-worldwide-problem-in-healthcare
#5
EDITORIAL
John Brodersen
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. Therefore, treating an overdiagnosed condition (deviation, abnormality, risk factor, pathology) cannot, by definition, improve the patient's prognosis, and can therefore only be harmful. Overdiagnosis is an extremely harmful and big problem all over the world, and the problem is increasing...
September 2017: Zdravstveno Varstvo
https://www.readbyqxmd.com/read/28700803/factors-associated-with-underestimation-of-invasive-cancer-in-patients-with-ductal-carcinoma-in-situ-precautions-for-active-surveillance
#6
Carlos Chavez de Paz Villanueva, Valentina Bonev, Maheswari Senthil, Naveenraj Solomon, Mark E Reeves, Carlos A Garberoglio, Jukes P Namm, Sharon S Lum
Importance: Recent recognition of the overdiagnosis and overtreatment of ductal carcinoma in situ (DCIS) detected by mammography has led to the development of clinical trials randomizing women with non-high-grade DCIS to active surveillance, defined as imaging surveillance with or without endocrine therapy, vs standard surgical care. Objective: To determine the factors associated with underestimation of invasive cancer in patients with a clinical diagnosis of non-high-grade DCIS that would preclude active surveillance...
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28700164/-the-evolution-of-imaging-techniques-for-the-diagnosis-of-pulmonary
#7
Helia Robert-Ebadi, Frédéric Glauser, Sara Manzocchi Besson, Marc Blondon, Fatima Mahhou-Sennouni, Marc Righini
Modern diagnostic strategies for pulmonary embolism (PE) rely on the sequential use of clinical probability assessment, D-dimer and thoracic imaging when necessary. Computed tomography pulmonary angiography (CTPA) has become the imaging modality of choice. Diagnostic strategies using CTPA are very safe for the diagnosis of PE and have been well validated in large prospective management outcome studies. With the widespread use of CTPA, concerns regarding radiation and overdiagnosis of PE have paved the way for investigating new diagnostic modalities...
December 7, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28698318/words-do-matter-a-systematic-review-on-how-different-terminology-for-the-same-condition-influences-management-preferences
#8
Brooke Nickel, Alexandra Barratt, Tessa Copp, Ray Moynihan, Kirsten McCaffery
OBJECTIVES: Changing terminology for low-risk, screen-detected conditions has now been recommended by several expert groups in order to prevent overdiagnosis and reduce the associated harms of overtreatment. However, the effect of terminology on patients' preferences for management is not well understood. This review aims to synthesise existing studies on terminology and its impact on management decision making. DESIGN: Systematic review. METHODS: Studies were included that compared two or more terminologies to describe the same condition and measured the effect on treatment or management preferences and/or choices...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28693625/a-role-for-antimicrobial-stewardship-in-clinical-sepsis-pathways-a-prospective-interventional-study
#9
John Burston, Suman Adhikari, Andrew Hayen, Heather Doolan, Melissa L Kelly, Kathy Fu, Tomas O Jensen, Pamela Konecny
OBJECTIVE To evaluate the impact of early infectious diseases (ID) antimicrobial stewardship (AMS) intervention on inpatient sepsis antibiotic management. DESIGN Interventional, nonrandomized, controlled study. SETTING Tertiary-care referral hospital, Sydney, Australia. PATIENTS Consecutive, adult, non-intensive care unit (non-ICU) inpatients triggering an institutional clinical sepsis pathway from May to August 2015. INTERVENTION All patients reviewed by an ID Fellow within 24 hours of sepsis pathway trigger underwent case review and clinic file documentation of recommendations...
July 11, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28692457/the-thyroid-cancer-epidemic-2017-perspective
#10
Benjamin R Roman, Luc G Morris, Louise Davies
PURPOSE OF REVIEW: Thyroid cancer incidence and mortality trends have been identified as being consistent with overdiagnosis, and several recent efforts have been made to mitigate this problem. RECENT FINDINGS: Major guidelines for thyroid nodule management recommend against general biopsy of nodules less than 1 cm in size. Data supporting the safety of active surveillance of low-risk thyroid cancers is now recognized. Tumors previously labeled as encapsulated follicular variant papillary thyroid cancers are now recommended to be called noninvasive follicular thyroid neoplasm with papillary-like nuclear features...
July 7, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28688654/thyroid-cancer-is-more-likely-to-be-detected-incidentally-on-imaging-in-private-hospital-patients
#11
Jonathan Zagzag, Alexander Kenigsberg, Kepal N Patel, Keith S Heller, Jennifer B Ogilvie
BACKGROUND: The incidence of well-differentiated thyroid cancer (WDTC) is increasing. Patients with higher socioeconomic status have higher rates of WDTC, possibly due to increased imaging and overdiagnosis. We compared methods of WDTC diagnosis in patients treated at a public and an adjacent private university hospital. MATERIALS AND METHODS: Patients with WDTC at the two hospitals between 2004 and 2010 were included. Patients were categorized into having their WDTC discovered on physical examination or on unrelated imaging...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28673474/new-developments-and-future-challenges-of-nuclear-medicine-and-molecular-imaging-for-pulmonary-embolism
#12
Pierre-Yves Le Roux, Philippe Robin, Pierre-Yves Salaun
Although widely validated, current tests for pulmonary embolism (PE) diagnosis, i.e. computed tomography pulmonary angiography (CTPA) and V/Q planar scintigraphy, have some limitations. Drawbacks of CTPA include the radiation dose, some contra indications and a rising concern about a possible overdiagnosis/overtreatment of PE. On the other hand, V/Q planar scintigraphy has a high rate of non-diagnostic tests responsible for complex diagnostic algorithms. Since the PIOPED study, imaging equipment and radiopharmaceuticals have greatly evolved allowing the introduction of techniques that improve imaging of lung ventilation and perfusion...
June 27, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28671347/diagnosis-of-acute-pulmonary-embolism
#13
M Righini, H Robert-Ebadi, G Le Gal
Advances in the management of patients with suspected pulmonary embolism (PE) have improved diagnostic accuracy and made management algorithms safer, easier to use, and well standardized. These diagnostic algorithms are mainly based on the assessment of clinical pretest probability, D-dimer measurement, and imaging tests-predominantly computed tomography pulmonary angiography. These diagnostic algorithms allow safe and cost-effective diagnosis for most patients with suspected PE. In this review, we summarize signs and symptoms of PE, current existing evidence for PE diagnosis, and focus on the challenge of diagnosing PE in special patient populations, such as pregnant women, or patients with a prior VTE...
July 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28668410/focal-lesions-in-cirrhosis-not-always-hcc
#14
Maxime Ronot, Marco Dioguardi Burgio, Yvonne Purcell, Romain Pommier, Giuseppe Brancatelli, Valérie Vilgrain
Even though most hepatocellular carcinomas (HCC) develop in the setting of cirrhosis, numerous other focal liver lesions and pseudolesions may be encountered. The role of the radiologist is therefore to differentiate these lesions from HCC to avoid under- and overdiagnosis. There are several ways of classifying these lesions: those which predate the development of fibrosis and cirrhosis (cystic lesions, hemangioma), those related to or a consequence of cirrhosis (regenerative nodules, dysplastic nodules, focal fibrosis, peribiliary cysts, shunts, or even cholangiocarcinoma), and those related to the underlying cause of chronic liver disease (lymphoma)...
August 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28662267/impact-of-extending-screening-mammography-to-older-women-information-to-support-informed-choices
#15
Gemma Jacklyn, Kirsten Howard, Les Irwig, Nehmat Houssami, Jolyn Hersch, Alexandra Barratt
From 2013 through 2017, the Australian national breast cancer screening program is gradually inviting women aged 70-74 years to attend screening, following a policy decision to extend invitations to older women. We estimate the benefits and harms of the new package of biennial screening from age 50-74 compared to the previous programme of screening from age 50-69. Using a Markov model, we applied estimates of the relative risk reduction for breast cancer mortality and the risk of overdiagnosis from the Independent UK Panel on Breast Cancer Screening review to Australian breast cancer incidence and mortality data...
June 29, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28647893/the-overdiagnosis-of-what-on-the-relationship-between-the-concepts-of-overdiagnosis-disease-and-diagnosis
#16
Bjørn Hofmann
Overdiagnosis and disease are related concepts. Widened conceptions of disease increase overdiagnosis and vice versa. This is partly because there is a close and complex relationship between disease and overdiagnosis. In order to address the problems with overdiagnosis, we may benefit from a closer understanding this relationship. Accordingly, the objective of this article is to elucidate the relationship between disease and overdiagnosis. To do so, the article starts with scrutinizing how overdiagnosis can explain the expansion of the concept of disease...
June 24, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28647771/detection-of-potentially-relevant-extracolonic-and-colorectal-findings-at-ct-colonography-in-a-low-risk-symptomatic-patient-population
#17
F R S Netz, P J Pickhardt, M L G Janssen Heijnen, P C G Simons
PURPOSE: CT colonography (CTC) is a widely accepted examination tool for detection of colorectal lesions but evidence of the proportions of relevant extracolonic findings (ECF) in a large symptomatic but still relatively low-risk cohort is lacking, as well as their relationship to symptoms, age, and sex. METHODS: All patients (n = 3208) with colorectal symptoms, imaged between January 2007 and September 2016 with first-time CTC, were retrospectively selected. The majority (96...
June 24, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28647216/characteristics-of-prostate-cancer-found-at-fifth-screening-in-the-european-randomized-study-of-screening-for-prostate-cancer-rotterdam-can-we-selectively-detect-high-grade-prostate-cancer-with-upfront-multivariable-risk-stratification-and-magnetic-resonance
#18
Arnout R Alberts, Ivo G Schoots, Leonard P Bokhorst, Frank-Jan H Drost, Geert J van Leenders, Gabriel P Krestin, Roy S Dwarkasing, Jelle O Barentsz, Fritz H Schröder, Chris H Bangma, Monique J Roobol
BACKGROUND: The harm of screening (unnecessary biopsies and overdiagnosis) generally outweighs the benefit of reducing prostate cancer (PCa) mortality in men aged ≥70 yr. Patient selection for biopsy using risk stratification and magnetic resonance imaging (MRI) may improve this benefit-to-harm ratio. OBJECTIVE: To assess the potential of a risk-based strategy including MRI to selectively identify men aged ≥70 yr with high-grade PCa. DESIGN, SETTING, AND PARTICIPANTS: Three hundred and thirty-seven men with prostate-specific antigen ≥3...
June 21, 2017: European Urology
https://www.readbyqxmd.com/read/28644335/practice-bulletin-number-179-breast-cancer-risk-assessment-and-screening-in-average-risk-women
#19
(no author information available yet)
Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about what age to start, what age to stop, and how frequently to recommend mammography screening in average-risk women (2-4)...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28644328/practice-bulletin-no-179-summary-breast-cancer-risk-assessment-and-screening-in-average-risk-women
#20
(no author information available yet)
Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about what age to start, what age to stop, and how frequently to recommend mammography screening in average-risk women (2-4)...
July 2017: Obstetrics and Gynecology
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