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Nature Medicine May 2024Cardiac magnetic resonance imaging (CMR) is the gold standard for cardiac function assessment and plays a crucial role in diagnosing cardiovascular disease (CVD)....
Cardiac magnetic resonance imaging (CMR) is the gold standard for cardiac function assessment and plays a crucial role in diagnosing cardiovascular disease (CVD). However, its widespread application has been limited by the heavy resource burden of CMR interpretation. Here, to address this challenge, we developed and validated computerized CMR interpretation for screening and diagnosis of 11 types of CVD in 9,719 patients. We propose a two-stage paradigm consisting of noninvasive cine-based CVD screening followed by cine and late gadolinium enhancement-based diagnosis. The screening and diagnostic models achieved high performance (area under the curve of 0.988 ± 0.3% and 0.991 ± 0.0%, respectively) in both internal and external datasets. Furthermore, the diagnostic model outperformed cardiologists in diagnosing pulmonary arterial hypertension, demonstrating the ability of artificial intelligence-enabled CMR to detect previously unidentified CMR features. This proof-of-concept study holds the potential to substantially advance the efficiency and scalability of CMR interpretation, thereby improving CVD screening and diagnosis.
Topics: Humans; Cardiovascular Diseases; Artificial Intelligence; Female; Male; Middle Aged; Magnetic Resonance Imaging; Magnetic Resonance Imaging, Cine; Mass Screening; Aged; Adult
PubMed: 38740996
DOI: 10.1038/s41591-024-02971-2 -
Journal of Clinical Sleep Medicine :... Dec 2023
Topics: Humans; Risk Factors; Mass Screening
PubMed: 38041535
DOI: 10.5664/jcsm.10792 -
JAMA Jul 2023Familial hypercholesterolemia and multifactorial dyslipidemia are 2 conditions that cause abnormally high lipid levels in children, which can lead to premature...
IMPORTANCE
Familial hypercholesterolemia and multifactorial dyslipidemia are 2 conditions that cause abnormally high lipid levels in children, which can lead to premature cardiovascular events (eg, myocardial infarction and stroke) and death in adulthood.
OBJECTIVE
The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for lipid disorders in asymptomatic children and adolescents.
POPULATION
Asymptomatic children and adolescents 20 years or younger without a known diagnosis of a lipid disorder.
EVIDENCE ASSESSMENT
The USPSTF concludes that the current evidence is insufficient and the balance of benefits and harms for screening for lipid disorders in asymptomatic children and adolescents 20 years or younger cannot be determined.
RECOMMENDATION
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for lipid disorders in children and adolescents 20 years or younger. (I statement).
Topics: Adolescent; Child; Humans; Advisory Committees; Dyslipidemias; Lipids; Mass Screening; Preventive Health Services; Risk Assessment; Young Adult; Asymptomatic Diseases; Cardiovascular Diseases
PubMed: 37462699
DOI: 10.1001/jama.2023.11330 -
Academic Pediatrics 2023
Review
Topics: Humans; Caregivers; Mass Screening; Social Determinants of Health; Food Supply
PubMed: 37354949
DOI: 10.1016/j.acap.2023.06.022 -
Deutsches Arzteblatt International Dec 2023Good sleep is correlated with health. Primary insomnia is a common reason for consulting a primary care physician. It is usually treated with drugs despite clear... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Good sleep is correlated with health. Primary insomnia is a common reason for consulting a primary care physician. It is usually treated with drugs despite clear evidence for the efficacy of behavioral therapy.
METHODS
We conducted a selective search of PubMed for German- and English-language reviews of the past decade that deal with the function and regulation of sleep in healthy individuals and/or the mechanism of action of currently used drugs and behavioral therapy.
RESULTS
The important functions of sleep include cleaning processes such as the elimination of metabolic products, e.g., amyloid, via the glymphatic system; consolidation of memory; and anabolic regulation of metabolism. Osteoporosis, which affects 10.5% of post-menopausal women, is much more common in those who have insomnia (odds ratio 9.3, 95% confidence interval [2.9; 29.6]). Among 82-year-old persons in good cognitive health, 13% of those who sleep best will go on to develop Alzheimer’s disease, compared to 20% of those who sleep worst. Hypnotic drugs and behavioral therapy can each prolong sleep by approximately 30 minutes. Drugs alter the architecture and function of sleep and have unfavorable consequences, such as a higher rate of falls (healthy individuals: 24.8 per 1000 person-years; persons with insomnia, 27.5; persons taking hypnotic drugs for insomnia, 33.0). Behavioral therapy is resource-intensive and requires the patient’s adherence, yet it has been demonstrated to be effective over the long term and is the treatment of choice.
CONCLUSION
Behavioral therapy is underused despite clear evidence of efficacy, while drugs are given too often. Better patient education and the use of digital applications might help increase the utilization of behavioral therapy for insomnia.
Topics: Male; Humans; Female; Lung Neoplasms; Early Detection of Cancer; Sleep Initiation and Maintenance Disorders; Mass Screening; Sleep
PubMed: 37942822
DOI: 10.3238/arztebl.m2023.0228 -
Current Opinion in Obstetrics &... Apr 2024Rates of gestational diabetes mellitus (GDM) throughout the world continue to increase associated with the increasing rates of obesity. Given this epidemiologic burden,... (Review)
Review
PURPOSE OF REVIEW
Rates of gestational diabetes mellitus (GDM) throughout the world continue to increase associated with the increasing rates of obesity. Given this epidemiologic burden, the importance of proper screening, diagnosis, and management cannot be understated. This review focuses on the current screening guidelines utilized throughout the world and new data recently published regarding the most optimal screening techniques and future directions for research.
RECENT FINDINGS
Despite unanimous opinion that GDM warrants screening, the optimal screening regimen remains controversial. Notably, in the United States per the consensus recommendation by the American College of Obstetrics and Gynecology and the Society for Maternal-Fetal Medicine, a 2-step screening approach is often used. Recently, there have been multiple studies published that have compared the 1-step and 2-step screening process with respect to GDM incidence and perinatal outcomes. These new findings are summarized below.
SUMMARY
Utilization of the 1-step screening as opposed to the 2-step screening results in an increased diagnosis of GDM without significant population level benefit in outcomes. However, these studies remain underpowered to allow for meaningful comparison of outcomes in those diagnosed with GDM.
Topics: Pregnancy; Female; Humans; Diabetes, Gestational; Glucose Tolerance Test; Obstetrics; Gynecology; Mass Screening; Pregnancy Outcome
PubMed: 38259247
DOI: 10.1097/GCO.0000000000000940 -
World Journal of Gastroenterology Jan 2024Colorectal cancer (CRC) screening is a fundamental tool in the prevention and early detection of one of the most prevalent and lethal cancers. Over the years, screening,... (Review)
Review
Colorectal cancer (CRC) screening is a fundamental tool in the prevention and early detection of one of the most prevalent and lethal cancers. Over the years, screening, particularly in those settings where it is well organized, has succeeded in reducing the incidence of colon and rectal cancer and improving the prognosis related to them. Despite considerable advancements in screening technologies and strategies, the effectiveness of CRC screening programs remains less than optimal. This paper examined the multifaceted reasons behind the persistent lack of effectiveness in CRC screening initiatives. Through a critical analysis of current methodologies, technological limitations, patient-related factors, and systemic challenges, we elucidated the complex interplay that hampers the successful reduction of CRC morbidity and mortality rates. While acknowledging the advancements that have improved aspects of screening, we emphasized the necessity of addressing the identified barriers comprehensively. This study aimed to raise awareness of how important CRC screening is in reducing costs for this disease. Screening and early diagnosis are not only important in improving the prognosis of patients with CRC but can lead to an important reduction in the cost of treating a disease that is often diagnosed at an advanced stage. Spending more sooner can mean saving money later.
Topics: Humans; Colonic Neoplasms; Colorectal Neoplasms; Early Detection of Cancer; Prognosis; Rectal Neoplasms; Mass Screening; Colonoscopy
PubMed: 38314134
DOI: 10.3748/wjg.v30.i3.211 -
Missouri Medicine 2024The incidence of diabetes and hyperlipidemia are increasing at rapid rates in children. These conditions are associated with increased risk of macrovascular and... (Review)
Review
The incidence of diabetes and hyperlipidemia are increasing at rapid rates in children. These conditions are associated with increased risk of macrovascular and microvascular complications causing major morbidity and mortality later in life. Early diagnosis and treatment can reduce the lifelong risk of complications from these diseases, exemplifying the importance of screening in the pediatric population. The following article presents a summary of the current guidelines for diabetes and hyperlipidemia screening in pediatric patients.
Topics: Humans; Child; Dyslipidemias; Mass Screening; Practice Guidelines as Topic; Diabetes Mellitus; Pediatrics; Hyperlipidemias; Adolescent
PubMed: 38854609
DOI: No ID Found -
Clinics (Sao Paulo, Brazil) 2024Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder, with main manifestations related to communication, social interaction, and behavioral... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder, with main manifestations related to communication, social interaction, and behavioral patterns. The slight dynamics of change in the child over time require that the onset of clinical manifestations presented by the child be more valued, with the aim of stabilizing the condition. Faced with a variety of methods for diagnosing ASD, the question arises as to which method should be used. This systematic review aims to recommend the best tools to perform screening and diagnosis.
METHODOLOGY
This systematic review followed the PRISMA guidelines. The databases MEDLINE, Embase, CENTRAL (Cochrane), and Lilacs were accessed, and gray and manual searches were performed. The search strategy was created with terms referring to autism and the diagnosis/broad filter. The studies were qualitatively evaluated and quantitatively. Statistical analysis was performed using Meta-diSc-2.0 software, the confidence interval was 95 %.
RESULTS
The M-CHAT-R/F tool demonstrated a sensitivity of 78 % (95 % CI 0.57‒0.91) and specificity of 0.98 (95 % CI 0.88-1.00). The diagnostic tools demonstrated sensitivity and specificity respectively of: ADOS, sensitivity of 87 % (95 % CI 0.79‒0.92) and specificity 75 % (95 % CI 0.73‒0.78); ADI-R demonstrated test sensitivity of 77 % (95 % CI 0.56‒0.90) and specificity 68 % (95 % CI 0.52‒0.81), CARS test sensitivity was 89 % (95 % CI 0.78‒0.95) and specificity 79 % (95 % CI 0.65‒0.88).
CONCLUSION
It is mandatory to apply a screening test, the most recommended being the M-CHAT-R/F. For diagnosis CARS and ADOS are the most recommended tools.
Topics: Child; Humans; Autism Spectrum Disorder; Sensitivity and Specificity; Mass Screening; Communication; Research Design
PubMed: 38484581
DOI: 10.1016/j.clinsp.2023.100323 -
Lancet (London, England) Aug 2023
Topics: Humans; Artificial Intelligence; Early Detection of Cancer; Mass Screening; Neoplasms
PubMed: 37544321
DOI: 10.1016/S0140-6736(23)01576-3