Search results for "Overdiagnosis"
showing 8 items of 18 documents
Validation of lung densitometry threshold at CT for the distinction between senile lung and emphysema in elderly subjects
2015
Background and Aims. An ageing lung is characterised by distal airspace enlargement without alveolar wall destruction: therefore the anatomical distinction between senile lung and emphysema is clear-cut. In clinical settings the definition of precise boundaries between normalcy and pathology is more difficult with the risk of overdiagnosis. CT is an important diagnostic advancement in the field of COPD. Most methods for the evaluation of emphysema are based on the detection and measurement of areas characterised by a density level below a threshold assumed to characterize parenchymal destruction. Methods. Our retrospective study included 47 healthy subjects (65-91 years), 36 never smokers a…
Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome
2010
Current IASP diagnostic criteria for CRPS have low specificity, potentially leading to overdiagnosis. This validation study compared current IASP diagnostic criteria for CRPS to proposed new diagnostic criteria (the "Budapest Criteria") regarding diagnostic accuracy. Structured evaluations of CRPS-related signs and symptoms were conducted in 113 CRPS-I and 47 non-CRPS neuropathic pain patients. Discriminating between diagnostic groups based on presence of signs or symptoms meeting IASP criteria showed high diagnostic sensitivity (1.00), but poor specificity (0.41), replicating prior work. In comparison, the Budapest clinical criteria retained the exceptional sensitivity of the IASP criteria…
GOLD and the fixed ratio
2012
We thank Dr Vestbo for his interest in our manuscript “Diagnosis of airway obstruction in the elderly: contribution of the SARA study” and for the opportunity to clarify some points. As mentioned in the title and aims, the intent of the paper is to offer a contribution to the open issue of identification of airway obstruction in elderly people.1 We agree with Dr Vestbo about the utility of distinguishing between the clinical and functional aspects of chronic obstructive pulmonary disease (COPD). We stress that, until the term COPD is used, diagnosis needs clinical evidence of a chronic pulmonary disease and functional evidence of airway obstruction. Given that symptoms compatible with COPD …
Stage and Grade Migration in Prostate Cancer Treated With Radical Prostatectomy in a Large German Multicenter Cohort.
2020
Abstract Introduction Overdiagnosis and overtherapy in prostate cancer (PCa) treatment should be avoided, which has led to an awareness of the need to decrease treatment in cases of low-risk PCa with radical prostatectomy (RP). Simultaneously, prostate-specific antigen testing has become less popular in the last few years, which has resulted in higher cancer grade and stage at diagnosis. We evaluated stage and grade migration in the disease of patients treated with RP in a large German cohort. Patients and Methods Overall, 4842 patients undergoing RP between 2000 and 2019 were included. Age, prostate-specific antigen level, biopsy, and pathologic Gleason score as well as clinical and pathol…
Lead-time and overdiagnosis estimation in neuroblastoma screening.
2003
In Germany, neuroblastoma is the most frequent extracranial solid childhood tumour. Its properties made it seem an ideal candidate for screening. A German trial assessed the effect of screening at one year of age from 1995-2001 in a nationwide project. We present here the methods developed for the estimation of lead-time and overdiagnosis in this project. Follow up on 1.5 million screened children and 2.1 million control children is currently available until June 2002. Ascertainment of control cohort cases and false negative cases is complete up to this date. A method for determining an empirical lead-time distribution and overdiagnosis estimate from comparing the age specific incidences in…
A Probabilistic Classification Procedure Based on Response Time Analysis Towards a Quick Pre-Diagnosis of Student's Attention Deficit
2019
[EN] A classification methodology based on an experimental study is proposed towards a fast pre-diagnosis of attention deficit. Our sample consisted of school-aged children between 8 and 12 years from Valencia, Spain. The study was based on the response time (RT) to visual stimuli in computerized tasks. The process of answering consecutive questions usually follows an ex-Gaussian distribution of the RTs. Specifically, we seek to propose a simple automatic classification scheme of children based on the most recent evidence of the relationship between RTs and ADHD. Specifically, the prevalence percentage and reported evidence for RTs in relation to ADHD or to attention deficit symptoms were t…
Neuroblastoma in Europe: differences in the pattern of disease in the UK
1998
Summary Background Neuroblastoma is a major contributor to childhood cancer mortality, but its prognosis varies with age and stage of disease, and some tumours regress spontaneously. Urinary screening programmes or clinical examination may detect the disease before symptoms appear, but the benefit of early diagnosis is uncertain. We examined the incidence, pattern, and presentation of neuroblastoma in four European countries. Methods Population-based incidence rates were derived for France, Austria, Germany, and the UK. Age, sex, and stage distribution were analysed by Mantel-Haenszel techniques and Poisson regression. The proportion of incidental diagnoses (cases without symptoms found at …
Management of Pulmonary Embolism
2016
Pulmonary embolism (PE) remains a major contributor to global disease burden. Risk-adapted treatment and follow-up contributes to a favorable outcome. Age-adjusted cutoff levels increase D-dimer specificity and may decrease overuse of imaging procedures and overdiagnosis of PE. Primary systemic fibrinolysis has an unfavorable risk-benefit ratio in intermediate-risk PE; catheter-directed techniques are an option for patients with hemodynamic decompensation and high bleeding risk. New oral anticoagulant agents are effective and safe alternatives to standard anticoagulation regimens. Recent trial data do not support insertion of cava filters in patients who can receive anticoagulant treatments…