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La Tunisie Medicale Jan 2020To report the conlcusions of articles and reviews assessing the benefit and harms of breast cancer screening in the world and in Tunisia. (Review)
Review
AIM
To report the conlcusions of articles and reviews assessing the benefit and harms of breast cancer screening in the world and in Tunisia.
METHODS
This is a review of articles searched through specialized medical data bases (Pubmud, Science Direct) using the following key-words: Dépistage / Screening,Cancer du sein/ Breast Cancer, Surdiagnostic/ Overdiagnosis,Mammographie/ Mammography,Controverse/ controversy,Tumeur in Situ/ In Situ Tumour.
RESULTS
We reviewed 36 articles published between 2001 and 2018 assessing the benefit of breast cancer screening. The mortality reduction due to breast cancer screening is estimated between 15-30% by the randomized trials. However, overdiagnosis is estimated between 0-50%.
CONCLUSION
Breast cancer screening has been useful in the fight against cancer. In the era of innovative and efficient therapies, breast cancer screening remains controversial due to the potential overdiagnosis. However, this concept still need to be defined more precisely and estimated more accuratly.
Topics: Breast Neoplasms; Early Detection of Cancer; Female; Humans; Mammography; Mass Screening; Randomized Controlled Trials as Topic; Tunisia
PubMed: 32395774
DOI: No ID Found -
JAMA Dec 2023
Topics: Female; Humans; Pregnancy; Depression; Depression, Postpartum; Postpartum Period; Prenatal Care; Mass Screening
PubMed: 38010647
DOI: 10.1001/jama.2023.21311 -
Psychiatry Research Sep 2020The Spielberger State-Trait Anxiety Inventory (STAI) has been widely used to measure the state and trait components of anxiety. We sought to develop a short, yet...
The Spielberger State-Trait Anxiety Inventory (STAI) has been widely used to measure the state and trait components of anxiety. We sought to develop a short, yet reliable and valid form of these scales for use in circumstances where the full-form is not feasible. We abbreviated the scales using item response theory analyses to retain the items that could discriminate the best among participants. One sample (N = 922) completed the state scale, a second sample (N = 2227) completed the trait scale, while a third sample (N = 250) completed the short forms. Our participants completed the Hungarian version of STAI alongside other measures to observe external validity. We calculated cut-off scores for the state (>9.5,) and trait (>13.5) scales. A total of 19.5% and 20.1% of the respondents reached the cut-off scores. The five-item short forms of STAI had sound psychometric properties that are comparable to those obtained on the full-form. The external validity of the scales is also demonstrated. We report detailed descriptive statistics that could be used in further studies as standards. The short scales are reliable measures that could be used in clinical screening and behavioural research; especially where practical considerations preclude the use of a longer questionnaire.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anxiety; Female; Humans; Male; Mass Screening; Middle Aged; Psychiatric Status Rating Scales; Psychometrics; Reproducibility of Results; Self Report; Surveys and Questionnaires; Young Adult
PubMed: 32563747
DOI: 10.1016/j.psychres.2020.113223 -
Primary Care Mar 2021The initial assessment of immigrant and refugee patients, including which health concerns to address and which infectious diseases may benefit from early screening, may... (Review)
Review
The initial assessment of immigrant and refugee patients, including which health concerns to address and which infectious diseases may benefit from early screening, may present challenges to clinicians. Evidence-based research suggests certain infectious diseases should be screened for and treated in refugees. Overseas refugee preemptive treatment programs have reduced the burden of some diseases but have not removed the value of in-country screening programs. This article provides discussion of a series of common tropical and infectious diseases providing refugee and geographic contexts and links to international resources that have been developed to improve the care of newly arriving immigrants and refugees.
Topics: Communicable Diseases; Emigrants and Immigrants; Humans; Mass Screening; Practice Guidelines as Topic; Refugees; United States
PubMed: 33516423
DOI: 10.1016/j.pop.2020.11.002 -
Primary Care Mar 2021The domestic medical examination of newly arrived refugees is a comprehensive medical visit. It includes a review of the overseas medical examination and a thorough... (Review)
Review
The domestic medical examination of newly arrived refugees is a comprehensive medical visit. It includes a review of the overseas medical examination and a thorough medical and immigration history. It should include laboratory testing for infectious diseases, pregnancy, and other conditions as recommended by the Centers for Disease Control and Prevention and resettlement state, as well as a comprehensive physical examination with attention paid to conditions known to specific refugee groups. It should also include vaccinations for age-appropriate vaccine-preventable diseases. The concept of preventive care should be introduced, and future visits should be scheduled for preventive care.
Topics: Contraceptive Agents; Health Status; Humans; Immunization; Mass Screening; Mental Health; Physical Examination; Preventive Health Services; Refugees
PubMed: 33516427
DOI: 10.1016/j.pop.2020.09.003 -
Circulation Research Jun 2020Atrial fibrillation (AF) is a common and morbid arrhythmia. Stroke is a major hazard of AF and may be preventable with oral anticoagulation. Yet since AF is often... (Review)
Review
Atrial fibrillation (AF) is a common and morbid arrhythmia. Stroke is a major hazard of AF and may be preventable with oral anticoagulation. Yet since AF is often asymptomatic, many individuals with AF may be unaware and do not receive treatment that could prevent a stroke. Screening for AF has gained substantial attention in recent years as several studies have demonstrated that screening is feasible. Advances in technology have enabled a variety of approaches to facilitate screening for AF using both medical-prescribed devices as well as consumer electronic devices capable of detecting AF. Yet controversy about the utility of AF screening remains owing to concerns about potential harms resulting from screening in the absence of randomized data demonstrating effectiveness of screening on outcomes such as stroke and bleeding. In this review, we summarize current literature, present technology, population-based screening considerations, and consensus guidelines addressing the role of AF screening in practice.
Topics: Atrial Fibrillation; Electrocardiography; Heart Rate Determination; Humans; Mass Screening; Practice Guidelines as Topic
PubMed: 32716713
DOI: 10.1161/CIRCRESAHA.120.316341 -
Indian Journal of Cancer 2019
Topics: Decision Making, Shared; Early Detection of Cancer; Humans; Mass Screening; Neoplasms
PubMed: 31389379
DOI: 10.4103/ijc.IJC_574_18 -
BMJ (Clinical Research Ed.) Sep 2021To examine the accuracy of artificial intelligence (AI) for the detection of breast cancer in mammography screening practice.
OBJECTIVE
To examine the accuracy of artificial intelligence (AI) for the detection of breast cancer in mammography screening practice.
DESIGN
Systematic review of test accuracy studies.
DATA SOURCES
Medline, Embase, Web of Science, and Cochrane Database of Systematic Reviews from 1 January 2010 to 17 May 2021.
ELIGIBILITY CRITERIA
Studies reporting test accuracy of AI algorithms, alone or in combination with radiologists, to detect cancer in women's digital mammograms in screening practice, or in test sets. Reference standard was biopsy with histology or follow-up (for screen negative women). Outcomes included test accuracy and cancer type detected.
STUDY SELECTION AND SYNTHESIS
Two reviewers independently assessed articles for inclusion and assessed the methodological quality of included studies using the QUality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A single reviewer extracted data, which were checked by a second reviewer. Narrative data synthesis was performed.
RESULTS
Twelve studies totalling 131 822 screened women were included. No prospective studies measuring test accuracy of AI in screening practice were found. Studies were of poor methodological quality. Three retrospective studies compared AI systems with the clinical decisions of the original radiologist, including 79 910 women, of whom 1878 had screen detected cancer or interval cancer within 12 months of screening. Thirty four (94%) of 36 AI systems evaluated in these studies were less accurate than a single radiologist, and all were less accurate than consensus of two or more radiologists. Five smaller studies (1086 women, 520 cancers) at high risk of bias and low generalisability to the clinical context reported that all five evaluated AI systems (as standalone to replace radiologist or as a reader aid) were more accurate than a single radiologist reading a test set in the laboratory. In three studies, AI used for triage screened out 53%, 45%, and 50% of women at low risk but also 10%, 4%, and 0% of cancers detected by radiologists.
CONCLUSIONS
Current evidence for AI does not yet allow judgement of its accuracy in breast cancer screening programmes, and it is unclear where on the clinical pathway AI might be of most benefit. AI systems are not sufficiently specific to replace radiologist double reading in screening programmes. Promising results in smaller studies are not replicated in larger studies. Prospective studies are required to measure the effect of AI in clinical practice. Such studies will require clear stopping rules to ensure that AI does not reduce programme specificity.
STUDY REGISTRATION
Protocol registered as PROSPERO CRD42020213590.
Topics: Artificial Intelligence; Breast Neoplasms; Early Detection of Cancer; Female; Humans; Mammography; Mass Screening
PubMed: 34470740
DOI: 10.1136/bmj.n1872 -
The New England Journal of Medicine Mar 2024
Topics: Humans; Early Detection of Cancer; Colorectal Neoplasms; Mass Screening
PubMed: 38477992
DOI: 10.1056/NEJMe2400366 -
Journal of Internal Medicine Apr 2021
Topics: Humans; Mass Screening
PubMed: 33340170
DOI: 10.1111/joim.13216