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Latest & greatest articles for screening
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Screening for Breast Cancer in Average-Risk Women: A Guidance Statement From the American College of Physicians. The purpose of this guidance statement is to provide advice to clinicians on breast cancer screening in average-risk women based on a review of existing guidelines and the evidence they include.This guidance statement is derived from an appraisal of selected guidelines from around the world that address breast cancer screening, as well as their included evidence. All national (...) is all clinicians, and the target patient population is all asymptomatic women with average risk for breast cancer.In average-risk women aged 40 to 49 years, clinicians should discuss whether to screen for breast cancer with mammography before age 50 years. Discussion should include the potential benefits and harms and a woman's preferences. The potential harms outweigh the benefits in most women aged 40 to 49 years.In average-risk women aged 50 to 74 years, clinicians should offer screening
Prehospital stroke scales as screening tools for early identification of stroke and transient ischemic attack. Rapid and accurate detection of stroke by paramedics or other emergency clinicians at the time of first contact is crucial for timely initiation of appropriate treatment. Several stroke recognition scales have been developed to support the initial triage. However, their accuracy remains uncertain and there is no agreement which of the scales perform better.To systematically identify (...) and review the evidence pertaining to the test accuracy of validated stroke recognition scales, as used in a prehospital or emergency room (ER) setting to screen people suspected of having stroke.We searched CENTRAL, MEDLINE (Ovid), Embase (Ovid) and the Science Citation Index to 30 January 2018. We handsearched the reference lists of all included studies and other relevant publications and contacted experts in the field to identify additional studies or unpublished data.We included studies evaluating
Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. To determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression.Individual participant data meta-analysis.Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (January 2000-February 2015).Eligible studies compared PHQ-9 scores with major depression diagnoses from validated
Depression in primary care: part 1-screening and diagnosis. Depression is a common and heterogeneous condition with a chronic and recurrent natural course that is frequently seen in the primary care setting. Primary care providers play a central role in managing depression and concurrent physical comorbidities, and they face challenges in diagnosing and treating the condition. In this two part series, we review the evidence available to help to guide primary care providers and practices (...) to recognize and manage depression. In this first of two reviews, we outline an approach to screening and diagnosing depression in primary care that evaluates current evidence based guidelines and applies the recommendations to clinical practice. The second review presents an evidence based approach to the treatment of depression in primary care, detailing the recommended lifestyle, drug, and psychological interventions at the individual level. It also highlights strategies that are being adopted
Cervical screening and risk of adenosquamous and rare histological types of invasive cervical carcinoma: population based nested case-control study. To examine the association of cervical cytology screening with the risk of adenosquamous cell carcinoma (ASC) and rare histological types of invasive cervical carcinoma (RICC), using comprehensive registry data, and to assess tumour human papillomavirus status of ASC and RICC.Nationwide, population based, nested case-control study.Sweden.All cases (...) density sampling.Conditional logistic regression was used to calculate odds ratios, interpreted as incidence rate ratios, for risk of ASC and RICC in relation to screening status and screening history, adjusted for education. Human papillomavirus distribution of ASC and RICC was based on available archival tumour tissues from most Swedish pathology biobanks.Women with two screening tests in the previous two recommended screening intervals had a lower risk of ASC (incidence rate ratio 0.22, 95
Accuracy of Self-Report for Cervical and Breast Cancer Screening Management Briefs eBrief-no152 -- Accuracy of Self-Report for Cervical and Breast Cancer Screening Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs eBrief-no152 -- Accuracy of Self-Report for Cervical and Breast Cancer Screening Health Services Research & Development Management eBrief no. 152 » Issue 152 April 2019 (...) The report is a product of the VA/HSR&D Evidence Synthesis Program. Evidence Brief: Accuracy of Self-Report for Cervical and Breast Cancer Screening Guideline-based breast and cervical cancer screening are considered essential health benefits and are fundamental components of high-quality primary care services in the United States. The aim of cancer screening is to identify cancers in an early stage when treatment is more likely to be effective. Accurate measurement of cancer screening rates is vital
Elevated Blood Lead Levels in Children and Pregnant Women: Screening Final Update Summary: Elevated Blood Lead Levels in Children and Pregnant Women: Screening - US Preventive Services Task Force Search USPSTF Website Text size: Assembly version: 184.108.40.2068 Last Build: 11/16/2018 6:27:19 PM You are here: Final Summary Elevated Blood Lead Levels in Children and Pregnant Women: Screening Release Date: April 2019 Recommendation Summary Population Recommendation Grade Children 5 years and younger (...) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic children. Pregnant persons The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic pregnant persons. To read the recommendation statement in JAMA , select . To read the evidence summary in JAMA , select . See the for suggestions
Practice Advisory: Cell-free DNA to Screen for Single-Gene Disorders Practice Advisory: Cell-free DNA to Screen for Single-Gene Disorders - ACOG Menu ▼ Practice Advisory: Cell-free DNA to Screen for Single-Gene Disorders Page Navigation ▼ Share: Practice Advisory: Cell-free DNA to Screen for Single-Gene Disorders February 21, 2019 This is an area of evolving care and practice. Fellows should check periodically for revisions and updates. ACOG will communicate important changes and updates (...) to these guidelines. The continued innovation in cell-free technology combined with the desire for a maternal blood test to predict the risk for fetal genetic disorders during a pregnancy has broadened the application of cell-free DNA screening beyond aneuploidy to single-gene disorders. Examples of single-gene disorders include various skeletal dysplasias, sickle cell disease and cystic fibrosis. Although this technology is available clinically and marketed as a single-gene disorder prenatal screening option
Screening for Breast Cancer in Average-Risk Women ACP Guidance Statement on Breast Cancer Screening in Average-Risk Women | Annals of Internal Medicine | American College of Physicians '); } '); })(); Sign in below to access your subscription for full content INDIVIDUAL SIGN IN | You will be directed to acponline.org to register and create your Annals account INSTITUTIONAL SIGN IN | | Subscribe to Annals of Internal Medicine . You will be directed to acponline.org to complete your purchase (...) . Search Clinical Guidelines | 16 April 2019 Screening for Breast Cancer in Average-Risk Women: A Guidance Statement From the American College of Physicians Free Amir Qaseem, MD, PhD, MHA; Jennifer S. Lin, MD, MCR; Reem A. Mustafa, MD, MPH, PhD; Carrie A. Horwitch, MD, MPH; Timothy J. Wilt, MD, MPH; for the Clinical Guidelines Committee of the American College of Physicians Amir Qaseem, MD, PhD, MHA American College of Physicians, Philadelphia, Pennsylvania (A.Q.) Jennifer S. Lin, MD, MCR Kaiser
A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer The European Randomized study of Screening for Prostate Cancer (ERSPC) has previously demonstrated that prostate-specific antigen (PSA) screening decreases prostate cancer (PCa) mortality.To determine whether PSA screening decreases PCa mortality for up to 16yr and to assess results following adjustment for nonparticipation and the number of screening rounds attended.This multicentre population-based randomised (...) screening trial was conducted in eight European countries. Report includes 182160 men, followed up until 2014 (maximum of 16yr), with a predefined core age group of 162389 men (55-69yr), selected from population registry.The outcome was PCa mortality, also assessed with adjustment for nonparticipation and the number of screening rounds attended.The rate ratio of PCa mortality was 0.80 (95% confidence interval [CI] 0.72-0.89, p<0.001) at 16yr. The difference in absolute PCa mortality increased from 0.14
Participation and Ease of Use in Colorectal Cancer Screening: A Comparison of 2 Fecal Immunochemical Tests The impact of fecal immunochemical test (FIT)-based colorectal cancer (CRC) screening on disease incidence and mortality is affected by participation, which might be influenced by ease of use of the FIT. We compared the participation rates and ease of use of 2 different FITs in a CRC screening program.There were two study designs within the Dutch CRC screening program. In a paired cohort (...) but marginally considered easier to use than OC-Sensor, the number of analyzable tests and the participation rates in organized CRC screening are not affected when either of the FITs is implemented as a primary screening test.
Systematic screening and assessment of psychosocial well-being and care needs of people with cancer. Receiving a diagnosis of cancer and the subsequent related treatments can have a significant impact on an individual's physical and psychosocial well-being. To ensure that cancer care addresses all aspects of well-being, systematic screening for distress and supportive care needs is recommended. Appropriate screening could help support the integration of psychosocial approaches in daily routines (...) in order to achieve holistic cancer care and ensure that the specific care needs of people with cancer are met and that the organisation of such care is optimised.To examine the effectiveness and safety of screening of psychosocial well-being and care needs of people with cancer. To explore the intervention characteristics that contribute to the effectiveness of these screening interventions.We searched five electronic databases in January 2018: the Cochrane Central Register of Controlled Trials
Infographic: Disaster Triage Accuracy Following Screen-Based Simulation versus Immersive Simulation Infographic: Disaster Triage Accuracy Following Screen-Based Simulation versus Immersive Simulation - CanadiEM Infographic: Disaster Triage Accuracy Following Screen-Based Simulation versus Immersive Simulation In , by Anson Dinh March 15, 2019 In this issue, we collaborated with the INSPIRE (International Network for Simulation-based Pediatric Innovation, Research, & Education) team to create (...) an infographic on the article “Correlation Between Paramedic Disaster Triage Accuracy in Screen-Based Simulations and Immersive Simulations.” published by Cicero et al. 1 Screen-based simulation (SBS) is an emerging alternative to traditional teaching methods which require both learner and educator to be present. 2 SBS allows the learner freedom to learn at their own pace. This study investigated the impact of using SBS and automated feedback (demonstrated on the left side of the infographic). These results
Combining smoking cessation interventions with LDCT lung cancer screening: A systematic review Providing smoking cessation treatment with annual low dose CT (LDCT) screening offers an opportunity to reduce smoking-related morbidity and mortality. However, the optimal approach for delivering cessation interventions in the LDCT screening context is unknown. We searched for randomized controlled trials and observational studies with a control group testing a smoking cessation intervention among (...) adults undergoing LDCT screening through May 1, 2018 using MEDLINE, the Cochrane Library, Web of Science, EMBASE, PsycINFO, and ClinicalTrials.gov. Two reviewers independently reviewed each study to assess eligibility and extracted information using pre-specified protocols for included studies. Given significant differences in the interventions in each study, meta-analyses for the included studies could not be performed. Of 2513 identified studies, 9 met inclusion criteria. Five of the included
Newborn Screening for Severe Combined Immunodeficiency and T-cell Lymphopenia in California, 2010-2017 Newborn screening for severe combined immunodeficiency (SCID) was instituted in California in 2010. In the ensuing 6.5 years, 3 252 156 infants in the state had DNA from dried blood spots assayed for T-cell receptor excision circles (TRECs). Abnormal TREC results were followed-up with liquid blood testing for T-cell abnormalities. We report the performance of the SCID screening program (...) led to 94% survival. Infants with non-SCID TCL were also identified, diagnosed and managed, including 4 with complete DiGeorge syndrome who received thymus transplants. Although no cases of typical SCID are known to have been missed, 2 infants with delayed-onset leaky SCID had normal neonatal TREC screens but came to clinical attention at 7 and 23 months of age.Population-based TREC testing, although unable to detect immune defects in which T cells are present at birth, is effective
A cost-effectiveness analysis of a colorectal cancer screening program in safety net clinics STOP CRC is a cluster-randomized pragmatic study of a colorectal cancer (CRC) screening program within eight federally-qualified health centers (FQHCs) in Oregon and California promoting fecal immunochemical testing (FIT) with appropriate colonoscopy follow-up. Results are presented of a cost-effectiveness analysis of STOP CRC. Organization staff completed activity-based costing spreadsheets, assigning (...) labor hours by intervention activity and job-specific wage rates. Non-labor costs were from study data. Data were collected over February 2014-February 2016; analyses were performed in 2016-2017. Incremental cost-effectiveness ratios (ICERs) using completed FITs adjusted for number of screening-eligible patients (SEPs), as the effectiveness measure were calculated overall and by organization. Intervention delivery costs totaled $305 K across eight organizations (range: $10.2 K-$110 K). Overall
Clinical Reference Points for the Screen for Child Anxiety-related Disorders in 2 Investigations of Youth With Chronic Pain Anxiety is common in pediatric chronic pain and is related to a higher risk for poor outcomes; thus, there is a need for effective clinical screening methods to identify youth with chronic pain and co-occurring anxiety. The Screen for Child Anxiety-related Disorders (SCARED) is a validated measure that defines clinically significant anxiety using the traditional clinical (...) cut-off, but in pain populations, may fail to screen in youth with subclinical anxiety that may also be at increased risk. Two studies aimed to devise a clinically meaningful approach to capture anxiety severity in pediatric chronic pain.Study 1 (n=959) and Study 2 (n=207) were completed at 2 separate pediatric pain clinics, where the SCARED was administered along with measures of disability, activity limitations, pain intensity, quality of life, and pain catastrophizing. Groups with different
Performance of human papillomavirus testing on self-collected versus clinician-collected samples for the detection of cervical intraepithelial neoplasia of grade 2 or worse: a randomised, paired screen-positive, non-inferiority trial Human papillomavirus (HPV) testing on self-collected samples is a potential alternative to HPV testing on clinician-collected samples, but non-inferiority of its clinical accuracy remains to be assessed in the regular screening population. The IMPROVE study (...) was done to evaluate the clinical accuracy of primary HPV testing on self-collected samples within an organised screening setting.In this randomised, non-inferiority trial, women aged 29-61 years were invited to participate in the study as part of their regular screening invitation in the Netherlands. Women who provided informed consent were randomly allocated (1:1, with a block size of ten stratified by age) to one of two groups: a self-sampling group, in which women were requested to collect
Primary cervical screening with high risk human papillomavirus testing: observational study. To provide the first report on the main outcomes from the prevalence and incidence rounds of a large pilot of routine primary high risk human papillomavirus (hrHPV) testing in England, compared with contemporaneous primary liquid based cytology screening.Observational study.The English Cervical Screening Programme.578 547 women undergoing cervical screening in primary care between May 2013 and December (...) 2014, with follow-up until May 2017; 183 970 (32%) were screened with hrHPV testing.Routine cervical screening with hrHPV testing with liquid based cytology triage and two early recalls for women who were hrHPV positive and cytology negative, following the national screening age and interval recommendations.Frequency of referral for a colposcopy; adherence to early recall; and relative detection of cervical intraepithelial neoplasia grade 2 or worse from hrHPV testing compared with liquid based
Predictive performance of the competing risk model in screening for preeclampsia The established method of screening for preeclampsia is to identify risk factors from maternal demographic characteristics and medical history; in the presence of such factors the patient is classified as high risk and in their absence as low risk. However, the performance of such an approach is poor. We developed a competing risks model, which allows combination of maternal factors (age, weight, height, race (...) of the competing risks model in screening for preeclampsia by a combination of maternal factors, mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, referred to as the triple test, in a training data set for the development of the model and 2 validation studies.The data for this study were derived from 3 previously reported prospective, nonintervention, multicenter screening studies for preeclampsia in singleton pregnancies at 11+0 to 13+6 weeks' gestation. In all 3