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Latest & greatest articles for screening
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Hepatitis C Virus Screening and Care: Complexity of Implementation in Primary Care Practices Serving Disadvantaged Populations. Hepatitis C virus (HCV) disproportionately affects disadvantaged communities.To examine processes and outcomes of Screen, Treat, Or Prevent Hepatocellular Carcinoma (STOP HCC), a multicomponent intervention for HCV screening and care in safety-net primary care practices.Mixed-methods retrospective analysis.5 federally qualified health centers (FQHCs) and 1 family (...) with chronic HCV in 4 practices, quantitative data also enabled assessment of HCV staging, specialist teleconsultation, direct-acting antiviral (DAA) treatment, and sustained virologic response (SVR). Implementation fidelity and adaptation were assessed qualitatively.Anti-HCV screening was done in 13 334 of 27 700 baby boomers (48.1%, varying by practice from 19.8% to 71.3%). Of 695 anti-HCV-positive patients, HCV RNA was tested in 520 (74.8%; 48.9% to 92.9% by practice), and 349 persons (2.6% of those
Screening for Abdominal Aortic Aneurysm: US Preventive Services Task Force Recommendation Statement. An abdominal aortic aneurysm (AAA) is typically defined as aortic enlargement with a diameter of 3.0 cm or larger. The prevalence of AAA has declined over the past 2 decades among screened men 65 years or older in various European countries. The current prevalence of AAA in the United States is unclear because of the low uptake of screening. Most AAAs are asymptomatic until they rupture (...) . Although the risk for rupture varies greatly by aneurysm size, the associated risk for death with rupture is as high as 81%.To update its 2014 recommendation, the USPSTF commissioned a review of the evidence on the effectiveness of 1-time and repeated screening for AAA, the associated harms of screening, and the benefits and harms of available treatments for small AAAs (3.0-5.4 cm in diameter) identified through screening.This recommendation applies to asymptomatic adults 50 years or older. However
Should This Patient Be Screened for Atrial Fibrillation?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center. Atrial fibrillation (AFib) is the most common type of cardiac arrhythmia, affecting 2.7 million to 6.1 million persons in the United States. Although some persons with AFib have no symptoms, others do. For those without symptoms, AFib may be detected by 12-lead electrocardiogram (ECG), single-lead monitors (such as ambulatory blood pressure monitors and pulse oximeters (...) ), or consumer devices (such as wearable monitors and smartphones). Pulse palpation and heart auscultation also may detect AFib. In a systematic review, screening with ECG identified more new cases of AFib than no screening. Atrial fibrillation is an important cause of stroke, and without anticoagulant treatment, patients with AFib have approximately a 5-fold increased risk for stroke. The U.S. Preventive Services Task Force reviewed the benefits and harms of ECG screening for AFib in adults aged 65 years
Cost-Effectiveness Analysis of Lung Cancer Screening in the United States: A Comparative Modeling Study. Recommendations vary regarding the maximum age at which to stop lung cancer screening: 80 years according to the U.S. Preventive Services Task Force (USPSTF), 77 years according to the Centers for Medicare & Medicaid Services (CMS), and 74 years according to the National Lung Screening Trial (NLST).To compare the cost-effectiveness of different stopping ages for lung cancer screening.By (...) using shared inputs for smoking behavior, costs, and quality of life, 4 independently developed microsimulation models evaluated the health and cost outcomes of annual lung cancer screening with low-dose computed tomography (LDCT).The NLST; Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial; SEER (Surveillance, Epidemiology, and End Results) program; Nurses' Health Study and Health Professionals Follow-up Study; and U.S. Smoking History Generator.Current, former, and never-smokers aged
Colorectal cancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy Colorectal cancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy: a clinical practice guideline | The BMJ Intended for healthcare professionals Username * Password * Edition: Search form Search Search Colorectal cancer... Colorectal cancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy: a clinical practice guideline (Published 02 October 2019) Cite (...) this as: BMJ 2019;367:l5515 Visual summary of recommendation No screening FIT Every year FIT Every two years Sigmoidoscopy Single Colonoscopy Single Favours no screening Favours screening We suggest no screening Interventions compared Recommendations Screening options Population We suggest using a tool such as the QCancer® calculator to estimate the risk of colorectal cancer for each person in the next 15 years. This calculates risk, based on: Understanding a person’s risk of cancer can help to determine
Newborn screening for sickle cell disease 1 Translation of Chapters 1 to 6 of the final report S18-01 Screening auf Sichelzellkrankheit (SCD) bei Neugeborenen (Version 1.0; Status: 25 July 2019 [German original], 28 November 2019 [English translation]). Please note: This document was translated by an external translator and is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative and legally binding. Extract IQWiG (...) Reports – Commission No. S18-01 Newborn screening for sickle cell disease (SCD) 1 Extract of final report S18-01 Version 1.0 Newborn screening for sickle cell disease (SCD) 25 July 2019 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Newborn screening for sickle cell disease (SCD) Commissioning agency: Federal Joint Committee Commission awarded on: 28 June 2018 Internal Commission No.: S18-01
Cardiopulmonary exercise testing in a combined screening approach to individuate pulmonary arterial hypertension in systemic sclerosis The DETECT algorithm has been developed to identify SSc patients at risk for pulmonary arterial hypertension (PAH) yielding high sensitivity but low specificity, and positive predictive value. We tested whether cardiopulmonary exercise testing (CPET) could improve the performance of the DETECT screening strategy.Consecutive SSc patients over a 30-month period (...) were screened with the DETECT algorithm and positive subjects were referred for CPET before the execution of right-heart catheterization. The predictive performance of CPET on top of DETECT was evaluated and internally validated via bootstrap replicates.Out of 314 patients, 96 satisfied the DETECT application criteria and 54 were positive. PAH was ascertained in 17 (31.5%) and pre-capillary pulmonary hypertension in 23 (42.6%) patients. Within CPET variables, the slope of the minute ventilation
Evaluation of the C2HEST Risk Score as a Possible Opportunistic Screening Tool for Incident Atrial Fibrillation in a Healthy Population (From a Nationwide Danish Cohort Study) A simple clinical score, C2HEST (C2: CAD/COPD [1 point each]; H: Hypertension; E: Elderly [Age ≥75, doubled]; S: Systolic HF [doubled]; T: Thyroid disease [hyperthyroidism]) has been proposed to predict incident atrial fibrillation (AF), with good discrimination and internal calibration. To define high-risk patients (...) at particular age strata for incident AF in a nationwide population cohort, who could potentially be targeted for AF screening, we used a nationwide cohort study of all Danish citizen aged ≥65 years to evaluate the performance of the C2HEST score. "High risk" subjects at age 65, 70, and 75 had 5-year risks of new onset AF of 11.8%, 14.2% and 13.6%, respectively, and the corresponding event rates were 2.99, 3.67, and 3.38 per 100 person years, respectively. Associated hazard ratios (HR) were 4.08 (95
Helping physicians fatigued by TSH Screening and Subclinical Hypothyroidism Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research (...) . www.acfp.ca December 9, 2019 (en français) Helping physicians fatigued by TSH Screening and Subclinical Hypothyroidism Clinical Question: Is there evidence for screening for thyroid function or treating subclinical hypothyroidism? Bottom Line: There is no randomized controlled trial (RCT) of screening for thyroid function [ordering thyroid stimulating hormone (TSH) in non-pregnant healthy people]. Despite approximately 20 RCTs, there are no patient-oriented benefits (like preventing cardiovascular disease
Screening and Management of the Hyperandrogenic Adolescent ACOGCOMMITTEEOPINION Number 789 Committee on Adolescent Health Care This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Adolescent Health Care in collaboration with committee members Jennie Yoost, MD and Ashlyn Savage, MD. Screening and Management of the Hyperandrogenic Adolescent ABSTRACT: Although androgen excess can manifest in many ways, the most common and recognizable (...) of PCOS and those of normal puberty,whichmakesthediagnosisofPCOSintheadolescentdifficult.Treatmentofacneandhirsutismshould not be withheld during the ongoing longitudinal evaluation for possible PCOS. On physical examination, body mass index, blood pressure, and signs of hyperandrogenism, such as acne and hirsutism, should be evaluated. Although guidelines differ on recommended laboratory studies, most include measurement of total testoster- one, free testosterone, or both, and screening
The screening and management of newborns at risk for low blood glucose Hypoglycemia in the first hours to days after birth remains one of the most common conditions facing practitioners across Canada who care for newborns. Many cases represent normal physiologic transition to extrauterine life, but another group experiences hypoglycemia of longer duration. This statement addresses key issues for providers of neonatal care, including the definition of hypoglycemia, risk factors, screening (...) protocols, blood glucose levels requiring intervention, and managing care for this condition. Screening, monitoring, and intervention protocols have been revised to better identify, manage, and treat infants who are at risk for persistent, recurrent, or severe hypoglycemia. The role of dextrose gels in raising glucose levels or preventing more persistent hypoglycemia, and precautions to reduce risk for recurrence after leaving hospital, are also addressed. This statement differentiates between
Recommendation on screening adults for asymptomatic thyroid dysfunction in primary care Recommendation on screening adults for asymptomatic thyroid dysfunction in primary care | CMAJ Main menu User menu Search Search for this keyword Search for this keyword Guideline Recommendation on screening adults for asymptomatic thyroid dysfunction in primary care Richard Birtwhistle , Kate Morissette , James A. Dickinson , Donna L. Reynolds , Marc T. Avey , Francesca Reyes Domingo , Rachel Rodin (...) of Family Medicine and Community Health Sciences (Dickinson), University of Calgary, Alta.; Dalla Lana School of Public Health and Department of Family and Community Medicine (Reynolds), University of Toronto, Ont.; Department of Psychiatry (Thombs), Jewish General Hospital and McGill University, Montréal, Que. KEY POINTS The Canadian Task Force on Preventive Health Care strongly recommends against screening for thyroid dysfunction in asymptomatic nonpregnant adults. Screening for thyroid dysfunction
Summary of Cervical Cancer Screening Recommendations for Non-HIV Immunocompromised Women (current immunosuppressants are listed in Table 2). Women with RA and IBD not on immunosuppressants and women with DM were considered at no increased risk compared with the general population. Screening recommendations based on these risks are summarizedinTable3. REFERENCES 1. GrulichAE,vanLeeuwenMT,FalsterMO,etal.Incidence ofcancersin peoplewithHIV/AIDScomparedwithimmunosuppressedtransplant recipients (...) . If resultofcytologyisnormalandHPVisnegative,co-testingcanbe performedevery 3 y -Iftransplantbefore theage of21y, begin screening within1 yofsexualdebut -Continue screeningthroughout lifetime (older than 65y). Discontinue screeningbasedonshareddiscussionregardingqualityand durationoflife rather thanage -Screenpatientsondialysis and posttransplantsimilarly Allogeneichematopoietic stem cell transplant -Cytologyisrecommendedifyounger than 30y -Co-testingispreferred, but cytologyisacceptableif 30yorolder -Ifusing cytologyalone, perform
Sequential screening for lung cancer in a high-risk group: randomised controlled trial: LungSEARCH: a randomised controlled trial of Surveillance using sputum and imaging for the EARly detection of lung Cancer in a High-risk group Low-dose computed tomography (LDCT) screening detects early-stage lung cancer and reduces mortality. We proposed a sequential approach targeted to a high-risk group as a potentially efficient screening strategy.LungSEARCH was a national multicentre randomised trial (...) . Current/ex-smokers with mild/moderate chronic obstructive pulmonary disease (COPD) were allocated (1:1) to have 5 years surveillance or not. Screened participants provided annual sputum samples for cytology and cytometry, and if abnormal were offered annual LDCT and autofluorescence bronchoscopy (AFB). Those with normal sputum provided annual samples. The primary end-point was the percentage of lung cancers diagnosed at stage I/II (nonsmall cell) or limited disease (small cell).1568 participants were
Effect of Mailed Human Papillomavirus Test Kits vs Usual Care Reminders on Cervical Cancer Screening Uptake, Precancer Detection, and Treatment: A Randomized Clinical Trial In the United States, more than 50% of cervical cancers are diagnosed in underscreened women. Cervical cancer screening guidelines now include primary human papillomavirus (HPV) testing as a recommended strategy. Home-based HPV self-sampling is a viable option for increasing screening compliance and effectiveness; however (...) , US data are needed to inform health care system implementation.To evaluate effectiveness of mailed HPV self-sampling kits vs usual care reminders for in-clinic screening to increase detection and treatment of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and uptake of cervical cancer screening.Randomized clinical trial conducted in Kaiser Permanente Washington, a US integrated health care delivery system. Women aged 30 to 64 years with health plan enrollment for 3 years and 5 months