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Clinics in Chest Medicine Mar 2020Robust evidence exists in support of lung cancer (LC) screening with low-dose computed tomography in patients at high risk of developing LC; however, judicious patient... (Review)
Review
Robust evidence exists in support of lung cancer (LC) screening with low-dose computed tomography in patients at high risk of developing LC; however, judicious patient selection is necessary to obtain optimal benefit while minimizing harm. Several professional societies have published recommendations regarding patient selection criteria for screening. Multiple risk prediction models that include additional patient-specific risk factors have since been developed to more accurately predict risk of developing LC. Implementation of a new screening program requires thorough multidisciplinary planning and maintenance. Multisociety guidelines highlight 9 principal components to implement and maintain a successful program.
Topics: Early Detection of Cancer; Humans; Lung Neoplasms; Mass Screening
PubMed: 32008631
DOI: 10.1016/j.ccm.2019.10.006 -
JAMA Nov 2022
Topics: Humans; Mass Screening; Polysomnography; Sleep Apnea, Obstructive
PubMed: 36378207
DOI: 10.1001/jama.2022.20142 -
Lancet (London, England) Sep 2019Children bear a substantial burden of suffering when it comes to tuberculosis. Ironically, they are often left out of the scientific and public health advances that have... (Review)
Review
Children bear a substantial burden of suffering when it comes to tuberculosis. Ironically, they are often left out of the scientific and public health advances that have led to important improvements in tuberculosis diagnosis, treatment, and prevention over the past decade. This Series paper describes some of the challenges and controversies in paediatric tuberculosis, including the epidemiology and treatment of tuberculosis in children. Two areas in which substantial challenges and controversies exist (ie, diagnosis and prevention) are explored in more detail. This Series paper also offers possible solutions for including children in all efforts to end tuberculosis, with a focus on ensuring that the proper financial and human resources are in place to best serve children exposed to, infected with, and sick from all forms of tuberculosis.
Topics: Child; Contact Tracing; Humans; Mass Screening; Specimen Handling; Tuberculosis; Tuberculosis Vaccines; Vaccination
PubMed: 31526740
DOI: 10.1016/S0140-6736(19)32045-8 -
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 -
Best Practice & Research. Clinical... Jul 2020Thyroid disease can significantly impact the pregnant woman and her child. Human and animal studies have firmly linked overt hypothyroidism and overt hyperthyroidism to... (Review)
Review
Thyroid disease can significantly impact the pregnant woman and her child. Human and animal studies have firmly linked overt hypothyroidism and overt hyperthyroidism to miscarriage, preterm delivery and other adverse pregnancy outcomes. Overt hypothyroidism and overt hyperthyroidism affect 1% of all pregnancies. Treatment is widely available, and if detected early, results in decreased rates of adverse outcomes. Universal screening for thyroid disease in pregnancy can identify patients with thyroid disease requiring treatment, and ultimately decrease rates of complications. Universal screening is cost-effective compared to the currently accepted practice of targeted screening and may even be cost-saving in some healthcare systems. Targeted screening, which is recommended by most professional associations, fails to detect a large proportion of pregnant women with thyroid disease. In fact, an increasing number of providers are performing universal screening for thyroid disease in pregnancy, contrary to society guidelines. Limited evidence concerning the impact of untreated and treated subclinical disease and thyroid autoimmunity has distracted from the core rationale for universal screening - the beneficial impact of detecting and treating overt thyroid disease. Evidence supporting universal screening for overt disease stands independently from that of subclinical and autoimmune disease. The time to initiate universal screening is now.
Topics: Cost-Benefit Analysis; Female; Humans; Infant, Newborn; Mass Screening; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prenatal Diagnosis; Thyroid Diseases; Thyroid Function Tests
PubMed: 31530447
DOI: 10.1016/j.beem.2019.101320 -
Zhongguo Fei Ai Za Zhi = Chinese... Nov 2020Lung cancer is the most common malignant tumor in the world. The five-year survival rate is 19.7%, which seriously threatens human health. Lung cancer screening is an... (Review)
Review
Lung cancer is the most common malignant tumor in the world. The five-year survival rate is 19.7%, which seriously threatens human health. Lung cancer screening is an effective measure to reduce lung cancer mortality. Existing studies have shown that screening with low-dose computed tomography (LDCT) can reduce lung cancer deaths by 20%. Currently, lung cancer screening is recommended internationally and nationally. Studying the development status of lung cancer screening helps us to identify the high-risk groups of lung cancer, explore reasonable screening programs, improve the cost-effectiveness of screening and reduce the economic burden. Therefore, this article summarizes the current status of lung cancer screening, the cost-effectiveness of lung cancer screening and the existing problems as follows. .
Topics: Cost-Benefit Analysis; Humans; Lung Neoplasms; Mass Screening; Risk Factors; Tomography, X-Ray Computed
PubMed: 32819054
DOI: 10.3779/j.issn.1009-3419.2020.101.37 -
Cardiac Electrophysiology Clinics Mar 2021Atrial fibrillation (AF) is a major, preventable cause of stroke, whose prevalence is increasing with the aging of the population. There are safe and effective... (Review)
Review
Atrial fibrillation (AF) is a major, preventable cause of stroke, whose prevalence is increasing with the aging of the population. There are safe and effective anticoagulation therapies to prevent stroke and new technologies that can identify AF in asymptomatic individuals. Ongoing research will determine if AF screening is cost-effective and will define the best screening strategies. The effectiveness of AF screening can be enhanced by simultaneously screening for the cardiovascular conditions that predispose to the development and progression of AF and its complications. Future studies evaluating an integrated screening program on outcomes, health care utilization, and cost are needed.
Topics: Aged; Atrial Fibrillation; Cost-Benefit Analysis; Humans; Mass Screening; Middle Aged
PubMed: 33516401
DOI: 10.1016/j.ccep.2020.10.009 -
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 -
Best Practice & Research. Clinical... Jul 2020Thyroid dysfunction in pregnancy is strongly associated with adverse maternal and foetal outcomes. The effects of treatment are less clear. There is ongoing discussion... (Review)
Review
Thyroid dysfunction in pregnancy is strongly associated with adverse maternal and foetal outcomes. The effects of treatment are less clear. There is ongoing discussion on whom to treat, when to treat and whether treatment is beneficial. Although universal screening for thyroid disease during pregnancy increases diagnosis and treatment of thyroid dysfunction, there is currently insufficient evidence demonstrating a positive effect of screening on maternal and foetal outcomes. We therefore, at present, recommend against universal screening for thyroid disease before and during pregnancy.
Topics: Female; Humans; Mass Screening; Practice Guidelines as Topic; Predictive Value of Tests; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prevalence; Thyroid Diseases; Thyroid Function Tests
PubMed: 32622828
DOI: 10.1016/j.beem.2020.101429 -
World Journal of Gastroenterology Aug 2019Since its original application, gastrointestinal (GI) endoscopy has undergone many innovative transformations aimed at expanding the scope, safety, accuracy,... (Review)
Review
Since its original application, gastrointestinal (GI) endoscopy has undergone many innovative transformations aimed at expanding the scope, safety, accuracy, acceptability and cost-effectiveness of this area of clinical practice. One method of achieving this has been to reduce the caliber of endoscopic devices. We propose the collective term "Miniature GI Endoscopy". In this Opinion Review, the innovations in this field are explored and discussed. The progress and clinical use of the three main areas of miniature GI endoscopy (ultrathin endoscopy, wireless endoscopy and scanning fiber endoscopy) are described. The opportunities presented by these technologies are set out in a clinical context, as are their current limitations. Many of the positive aspects of miniature endoscopy are clear, in that smaller devices provide access to potentially all of the alimentary canal, while conferring high patient acceptability. This must be balanced with the costs of new technologies and recognition of device specific challenges. Perspectives on future application are also considered and the efforts being made to bring new innovations to a clinical platform are outlined. Current devices demonstrate that miniature GI endoscopy has a valuable place in investigation of symptoms, therapeutic intervention and screening. Newer technologies give promise that the potential for enhancing the investigation and management of GI complaints is significant.
Topics: Biomedical Technology; Endoscopy, Gastrointestinal; Equipment Design; Gastrointestinal Diseases; Humans; Inventions; Mass Screening; Miniaturization
PubMed: 31435163
DOI: 10.3748/wjg.v25.i30.4051