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Latest & greatest articles for screening
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Emergent Large Vessel Occlusion Screen Is an Ideal Prehospital Scale to Avoid Missing Endovascular Therapy in Acute Stroke Background and Purpose- The strong evidence of endovascular therapy in acute ischemic stroke patients with large vessel occlusion (LVO) is revealed. Such patients are required to direct transport to the hospital capable of endovascular therapy. There are several prehospital scales available for paramedics to predict LVO. However, they are time consuming, and several of them (...) include factors caused by other types than LVO. Therefore, we need a fast, simple, and reliable prehospital scale for LVO. Methods- We developed a new prehospital stroke scale, emergent large vessel occlusion (ELVO) screen, for paramedics to predict LVO. The study was prospectively performed by multistroke centers. When paramedics referred to stroke center to accept suspected stroke patients, we obtain the following information over the telephone. ELVO screen was designed focusing on cortical symptoms
Recommendations on screening for breast cancer in women 40-74 years of age who are not at increased risk Recommendations on screening for breast cancer in women aged 40–74 years who are not at increased risk for breast cancer | CMAJ Main menu User menu Search Search for this keyword Search for this keyword Guideline Recommendations on screening for breast cancer in women aged 40–74 years who are not at increased risk for breast cancer Scott Klarenbach , Nicki Sims-Jones , Gabriela Lewin (...) POINTS Low-certainty evidence indicates that screening for breast cancer with mammography results in a modest reduction in breast cancer mortality for women aged 40 to 74 years; the absolute benefit is lowest for women younger than 50 years. Screening may lead to overdiagnosis, resulting in unnecessary treatment of cancer that would not have caused harm in a woman’s lifetime and false-positive results that can lead to both physical and psychological consequences; overdiagnosis and false-positives
Canadian Cardiovascular Society/Canadian Heart Rhythm Society Joint Position Statement on the Cardiovascular Screening of Competitive Athletes Canadian Cardiovascular Society/Canadian Heart Rhythm Society Joint Position Statement on the Cardiovascular Screening of Competitive Athletes - Canadian Journal of Cardiology Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 35, Issue 1, Pages 1–11 Canadian Cardiovascular Society/Canadian (...) Heart Rhythm Society Joint Position Statement on the Cardiovascular Screening of Competitive Athletes Primary Panel (CCS Sport Group) : , x Amer M. Johri Affiliations Queen’s University, Kingston, Ontario, Canada Correspondence Corresponding author: Dr Amer M. Johri, MD, MSc, FRCPC, FASE, Queen’s University, Department of Medicine, Division of Cardiology, CINQ, 76 Stuart St, FAPC 3, Kingston, Ontario K7L 2V7, Canada. Tel.: +1-613-549-6666; fax: +1-613-533-6695. , MD, MSc, FRCPC, FASE (Co-chair
Clinical relevance of screening checklists for detecting cancer predisposition syndromes in Asian childhood tumours Assessment of cancer predisposition syndromes (CPS) in childhood tumours is challenging to paediatric oncologists due to inconsistent recognizable clinical phenotypes and family histories, especially in cohorts with unknown prevalence of germline mutations. Screening checklists were developed to facilitate CPS detection in paediatric patients; however, their clinical value have (...) yet been validated. Our study aims to assess the utility of clinical screening checklists validated by genetic sequencing in an Asian cohort of childhood tumours. We evaluated 102 patients under age 18 years recruited over a period of 31 months. Patient records were reviewed against two published checklists and germline mutations in 100 cancer-associated genes were profiled through a combination of whole-exome sequencing and multiplex ligation-dependent probe amplification on blood-derived genomic
Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults: US Preventive Services Task Force Recommendation Statement. Excessive alcohol use is one of the most common causes of premature mortality in the United States. From 2006 to 2010, an estimated 88 000 alcohol-attributable deaths occurred annually in the United States, caused by both acute conditions (eg, injuries from motor vehicle collisions) and chronic conditions (eg, alcoholic liver (...) disease). Alcohol use during pregnancy is also one of the major preventable causes of birth defects and developmental disabilities.To update the US Preventive Services Task Force (USPSTF) 2013 recommendation on screening for unhealthy alcohol use in primary care settings.The USPSTF commissioned a review of the evidence on the effectiveness of screening to reduce unhealthy alcohol use (defined as a spectrum of behaviors, from risky drinking to alcohol use disorder, that result in increased risk
Dental radiograph as an opportunistic screening tool for a colorectal cancer syndrome (CAT#3342) UTCAT3342, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Dental radiograph as an opportunistic screening tool for a colorectal cancer syndrome Clinical Question Does dental radiograph serve as an opportunistic screening tool for early detection of extraintestinal manifestations of Familial Adenomatous Polyposis (FAP (...) ) in children and adults? Clinical Bottom Line Incidental findings on dental radiographs could serve as screening tools for systemic diseases and syndromes. The attention should be raised when gene mutation, congenitally diseases or familial colorectal cancer are reported by patients during the medical history questionnaire. For patients with risk of FAP, the Dental panoramic radiographic score (DPRS) is inexpensive, and reinforce the referral for the further clinical investigation, gene mapping
Evaluating cognitive screening instruments with the "likelihood to be diagnosed or misdiagnosed" measure To calculate "number needed to diagnose" (NND), "number needed to predict" (NNP), and "number needed to misdiagnose" (NNM) for cognitive screening instruments which are commonly used in suspected dementia and mild cognitive impairment, and from these to calculate a "likelihood to be diagnosed or misdiagnosed" (LDM) metric as the ratio of NNM to either NND or NNP.Datasets from pragmatic (...) diagnostic test accuracy studies examining four commonly used cognitive screening instruments (Mini-Mental State Examination, MMSE; Montreal Cognitive Assessment, MoCA; Mini-Addenbrooke's Cognitive Examination, MACE; Six-item Cognitive Impairment Test, 6CIT) were analysed to calculate NND, NNP, and NNM, and from these derive values for LDM.Although all the tests had low NND and NNP as desired, NNM was also low. Hence, only MMSE and 6CIT achieved LDM > 1 for dementia diagnosis, and only MACE and 6CIT had
Inpatient disposition in overcrowded hospitals: is it safe and effective to use reverse triage and readmission screening tools for appropriate discharge? An observational prospective study of an Italian II level hospital Reverse triage (RT) identifies patients eligible for discharge and have been proposed to cope with daily surge. Nevertheless, early discharge could increase the rate of readmission. Our aim is to test the effectiveness and safety of RT alone and with readmission screening tools (...) ]). In the RT ≤3 group, all but one patient were alive and healthy at 7, 15, and 30 days. The HOSPITAL score seemed to have the best concordance with RT (84%), in comparison with the ISAR (52%) and the GFI (48%) scores. RT showed a low sensitivity (22%) and high specificity (95%), which was even higher when using RT associated with readmission screening tools.Reverse triage proved to be a safe and conservative tool, with high specificity alone and with readmission screening tools. RT correctly identifies
A Simple Screening Tool to Predict Outcomes in Older Adults Undergoing Emergency General Surgery To determine whether the Flemish version of the Triage Risk Screening Tool (fTRST) can be used to accurately assess frailty in an emergency setting.Prospective observational study.of a tertiary referral hospital.All individuals aged 70 and older consecutively admitted to the emergency surgery unit with an urgent need for abdominal surgery between December 2015 and May 2016 who met inclusion criteria (...) (N=110).Individuals were screened with the fTRST and additional metrics such as the age-adjusted Charlson Comorbidity Index and American Society of Anesthesiology score. Thirty- and 90-day postoperative complications where recorded. Regression analyses were performed to identify possible preoperative predictors of adverse outcomes.Thirty-day major complications (Clavien-Dindo Classification 3-5) occurred in 28.2% of participants (n=31). fTRST had the highest correlation with major complications
In patients with unprovoked VTE, does the addition of FDG PET/CT to a limited occult cancer screening strategy offer good value for money? A cost-effectiveness analysis from the publicly funded health care systems Unprovoked venous thromboembolism (VTE) may be the first manifestation of an undiagnosed cancer. We assessed the cost-effectiveness of 18F-Fluorodesoxyglucose Positron Emission/Computed Tomography (FDG PET/CT) plus limited screening and limited screening strategies in patients (...) screening strategy, the ICER of limited strategy plus FDG PET/CT scan was C$ 26,840.19 (95% CI: C$ 24,046.51; C$ 34,581.53) per one avoided case of delayed cancer diagnosis from the Ontario health system perspective and €16,370.45 (95% CI: € 9904.48; € 39,578.91) per one avoided case of delayed cancer diagnosis from the French health system perspective. The probabilities that addition of FDG PET/CT to limited screening is cost-effective rose with increasing willingness to pay values. Compared
Lung Cancer Screening New 2018 ACR Appropriateness Criteria ® 1 Lung Cancer Screening American College of Radiology ACR Appropriateness Criteria ® Lung Cancer Screening Variant 1: Lung cancer screening. Patient 55 to 80 years of age and 30 or more packs per year smoking history and currently smoke or have quit within the past 15 years. Procedure Appropriateness Category Relative Radiation Level CT chest without IV contrast screening Usually Appropriate ??? CT chest with IV contrast Usually (...) Not Appropriate ??? CT chest without and with IV contrast Usually Not Appropriate ??? FDG-PET/CT skull base to mid-thigh Usually Not Appropriate ???? MRI chest without and with IV contrast Usually Not Appropriate O MRI chest without IV contrast Usually Not Appropriate O Radiography chest Usually Not Appropriate ? Variant 2: Lung cancer screening. Patient 50 years of age or older and 20 or more packs per year history of smoking and one additional risk factor (ie, radon exposure or occupational exposure
Screening for Perinatal Depression INTERIM UPDATE ACOGCOMMITTEEOPINION Number 757 (Replaces Committee Opinion No. 630, May 2015) Committee on Obstetric Practice This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice. INTERIM UPDATE: This Committee Opinion is updated as highlighted to reflect a limited, focused change in the language and supporting evidence regarding prevalence, benefits of screening, and screening tools (...) . Screening for Perinatal Depression ABSTRACT: Perinatal depression, which includes major and minor depressive episodes that occur during pregnancy or in the first 12 months after delivery, is one of the most common medical complications during pregnancy and the postpartum period, affecting one in seven women. It is important to identify pregnant and postpartum women with depression because untreated perinatal depression and other mood disorders can have devastating effects. Several screening instruments
Are There Tools to Screen Children and Adolescents in the Emergency Department With Mental Health and Substance Abuse Issues? TAKE-HOME MESSAGE Modest-quality evidence suggests that clinical decision instruments may be useful in identifying children and adolescents at increased risk for alcohol abuse, suicide, and need for mental health admission. Are There Tools to Screen Children and Adolescents in the Emergency Department With Mental Health and Substance Abuse Issues? EBEM Commentators (...) Michael P. Wilson, MD, PhD Rawle A. Seupaul, MD Department of Emergency Medicine University of Arkansas for Medical Sciences Little Rock, AR Results Table 1. Helpful ED screening tools. Positive LR Negative LR Sensitivity, % (95% CI) Speci?city, % (95% CI) HEADS-ED 6.3 0.21 82 (NR) 87 (NR) ASQ 2.8 0.04 98 (91.7–99.7) 66 (55.2–75.0) DSM-IV 8.8 0.13 88 (NR) 90 (NR) LR, Likelihood ratio; CI, con?dence interval; NR, not reported; ASQ, Ask Suicide-Screening Questions. The HEADS-ED tool is used to predict
Screening for Lung Cancer: CHEST Guideline and Expert Panel Report Screening for Lung Cancer CHEST Guideline and Expert Panel Report Peter J. Mazzone, MD, MPH, FCCP; Gerard A. Silvestri, MD, FCCP; Sheena Patel, MPH; Jeffrey P. Kanne, MD, FCCP; Linda S. Kinsinger, MD; Renda Soylemez Wiener, MD, MPH; Guy Soo Hoo, MD, FCCP; and Frank C. Detterbeck, MD, FCCP BACKGROUND: Low-dose chest CTscreening for lung cancer has becomeastandard ofcare in the United States in the past few years, in large part (...) due to the results of the National Lung Screening Trial. The bene?t and harms of low-dose chest CT screening differ in both frequency and magnitude. The translation of a favorable balance of bene?t and harms into practice can be dif?cult. Here, we update the evidence base for the bene?t, harms, and implementation of low radiation dose chest CT screening. We use the updated evidence base to provide recommendations where the evidence allows, and statements based on experience and expert consensus
Prognostic Nutritional Index: an easy nutritional screening for patients with head and neck cancer? 30426972 2018 12 07 2059-7029 3 6 2018 ESMO open ESMO Open Prognostic Nutritional Index: an easy nutritional screening for patients with head and neck cancer? e000449 10.1136/esmoopen-2018-000449 Bossi Paolo P Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy. eng Journal Article 2018 10 24 England ESMO Open 101690685 2059-7029 nutrition
Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults: US Preventive Services Task Force Final Recommendation Statement. Intimate partner violence (IPV) and abuse of older or vulnerable adults are common in the United States but often remain undetected. In addition to the immediate effects of IPV, such as injury and death, there are other health consequences, many with long-term effects, including development of mental health conditions such as depression (...) , posttraumatic stress disorder, anxiety disorders, substance abuse, and suicidal behavior; sexually transmitted infections; unintended pregnancy; and chronic pain and other disabilities. Long-term negative health effects from elder abuse include death, higher risk of nursing home placement, and adverse psychological consequences.To update the US Preventive Services Task Force (USPSTF) 2013 recommendation on screening for IPV, elder abuse, and abuse of vulnerable adults.The USPSTF commissioned a review
Divergent Long-Term Detection Rates of Proximal and Distal Advanced Neoplasia in Fecal Immunochemical Test Screening Programs: A Retrospective Cohort Study. Short-term studies have reported that the fecal immunochemical test (FIT) is less accurate in detecting proximal than distal colorectal neoplasia.To assess the long-term detection rates for advanced adenoma and colorectal cancer (CRC), according to anatomical location.Retrospective study.Population-based, organized screening program (...) in the Veneto region of Italy.Persons aged 50 to 69 years who completed 6 rounds of FIT screening.At each screening round, the detection rates for advanced adenoma and cancer, as well as the proportional interval cancer rate (PICR), were calculated by anatomical location (proximal colon, distal colon, or rectum).Between 2002 and 2014, a total of 123 347 participants had 441 647 FITs. The numbers of advanced adenomas and cancer cases detected, respectively, were 1704 and 200 in the proximal colon, 3703
Should This Woman With Dense Breasts Receive Supplemental Breast Cancer Screening?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center. Breast cancer will develop in 12% of women during their lifetime and is the second leading cause of cancer death among U.S. women. Mammography is the most commonly used tool to screen for breast cancer. Considerable uncertainty exists regarding the age at which to begin screening and the optimal screening interval. Breast density is a risk factor (...) for breast cancer. In addition, for women with dense breasts, small tumors may be missed on mammography and the sensitivity of screening is diminished. At the time of publication, 35 states had passed laws mandating that breast density be reported in the letters that radiologists send to women with their mammogram results. The mandated language may be challenging for patients to understand, and such reporting may increase worry for women who are told that their risk for breast cancer is higher than