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The Journal of Adolescent Health :... Mar 2021Adolescence and young adulthood constitute a period when exploratory behaviors can evolve into risky behaviors. Most causes of adolescent ill health are preventable;... (Review)
Review
Adolescence and young adulthood constitute a period when exploratory behaviors can evolve into risky behaviors. Most causes of adolescent ill health are preventable; therefore, it is a priority to detect them early before they turn into health problems. Previsit multidomain psychosocial screening tools are used by professionals to detect and prioritize potentially problematic issues. In conjunction with appropriate clinician training, these tools have improved clinician screening rates in several areas of adolescent health. This article reviews existing multidomain previsit psychosocial screening tools developed in the 21st century and describes their characteristics using a systematic methodology. We reviewed 10,623 records to identify 15 different tools in use since 2000 and described their characteristics. Results show that all tools were developed in high-income countries. The tools provide sufficient coverage of many psychosocial domains relevant to young people's health. However, some psychosocial domains such as screen use and strengths are seldomly addressed. Furthermore, the tools rarely focus on young adults as a target population. Future research should assess the effectiveness, acceptability, and psychometric properties of validated psychosocial screening tools and examine how to expand their use in low- and middle-income countries.
Topics: Adolescent; Adult; Delivery of Health Care; Humans; Mass Screening; Psychometrics; Risk-Taking; Young Adult
PubMed: 33221191
DOI: 10.1016/j.jadohealth.2020.10.003 -
Asian Pacific Journal of Cancer... Jun 2021Although cervical cancer screening has been performed as a national program since 1983 in Japan, the participation rate has remained below 20%. Equity of access is a... (Review)
Review
BACKGROUND
Although cervical cancer screening has been performed as a national program since 1983 in Japan, the participation rate has remained below 20%. Equity of access is a basic requirement for cancer screening. However, taking smears from the cervix has been limited to gynecologists or obstetricians in Japan and it might be a barrier for accessibility. We examined the current access and its available human resources for cervical cancer screening in Japan.
METHODS
We analyzed the number of gynecologists and obstetricians among 47 prefectures based on a national survey. A systematic review was performed to clarify disparity and use of human resources in cervical cancer screening, diagnosis, and treatment for cervical cancers in Japan. Candidate literature was searched using Ovid-MEDLINE and Ichushi-Web until the end of January 2020. Then, a systematic review regarding accessibility to cervical cancer screening was performed. The results of the selected articles were summarized in the tables.
RESULTS
Although the total number of all physicians in Japan increased from 1996 to 2016, the proportion of gynecologists and obstetricians has remained at approximately 5% over the last 2 decades. 43.6% of municipalities have no gynecologists and obstetricians in 2016. Through a systematic review, 4 English articles and 1 Japanese article were selected. From these 5 articles, the association between human resources and participation rates in cervical cancer screening was examined in 2 articles.
CONCLUSIONS
The human resources for taking smears for cervical cancer screening has remained insufficient with a huge disparity among municipalities in Japan. To improve accessibility for cervical cancer screening another option which may be considered could be involving general physicians as potential smear takers.
Topics: Data Analysis; Female; Health Services Accessibility; Humans; Japan; Mass Screening; Uterine Cervical Neoplasms; Vaginal Smears; Workforce
PubMed: 34181323
DOI: 10.31557/APJCP.2021.22.6.1695 -
Journal of Atherosclerosis and... 2015Familial hypercholesterolemia is a genetic disorder associated with elevated LDL-cholesterol and high lifetime cardiovascular risk. Both clinical and molecular cascade... (Review)
Review
Familial hypercholesterolemia is a genetic disorder associated with elevated LDL-cholesterol and high lifetime cardiovascular risk. Both clinical and molecular cascade screening programs have been implemented to increase early definition and treatment. In this systematic review, we discuss the main issues found in 65 different articles related to cascade screening and familial hypercholesterolemia, covering a range of topics including different types/strategies, considerations both positive and negative regarding cascade screening in general and associated with the different strategies, cost and coverage consideration, direct and indirect contact with patients, public policy around life insurance and doctor-patient confidentiality, the "right to know," and public health concerns regarding familial hypercholesterolemia.
Topics: Adolescent; Adult; Cardiology; Cardiovascular Diseases; Child; Child, Preschool; Cholesterol, LDL; Cost-Benefit Analysis; Databases, Factual; Family Health; Female; Health Policy; Humans; Hyperlipidemias; Hyperlipoproteinemia Type II; Infant; Male; Mass Screening; Pathology, Molecular; Risk Factors; Workforce; Young Adult
PubMed: 26194978
DOI: 10.5551/jat.31237 -
BMJ (Clinical Research Ed.) Sep 2010To examine the evidence on the benefits and harms of screening for prostate cancer. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To examine the evidence on the benefits and harms of screening for prostate cancer.
DESIGN
Systematic review and meta-analysis of randomised controlled trials.
DATA SOURCES
Electronic databases including Medline, Embase, CENTRAL, abstract proceedings, and reference lists up to July 2010. Review methods Included studies were randomised controlled trials comparing screening by prostate specific antigen with or without digital rectal examination versus no screening. Data abstraction and assessment of methodological quality with the GRADE approach was assessed by two independent reviewers and verified by the primary investigator. Mantel-Haenszel and inverse variance estimates were calculated and pooled under a random effects model expressing data as relative risks and 95% confidence intervals.
RESULTS
Six randomised controlled trials with a total of 387 286 participants that met inclusion criteria were analysed. Screening was associated with an increased probability of receiving a diagnosis of prostate cancer (relative risk 1.46, 95% confidence interval 1.21 to 1.77; P<0.001) and stage I prostate cancer (1.95, 1.22 to 3.13; P=0.005). There was no significant effect of screening on death from prostate cancer (0.88, 0.71 to 1.09; P=0.25) or overall mortality (0.99, 0.97 to 1.01; P=0.44). All trials had one or more substantial methodological limitations. None provided data on the effects of screening on participants' quality of life. Little information was provided about potential harms associated with screening.
CONCLUSIONS
The existing evidence from randomised controlled trials does not support the routine use of screening for prostate cancer with prostate specific antigen with or without digital rectal examination.
Topics: Age Factors; Aged; Aged, 80 and over; Cause of Death; Digital Rectal Examination; Evidence-Based Medicine; Humans; Male; Mass Screening; Middle Aged; Prostatic Neoplasms; Randomized Controlled Trials as Topic
PubMed: 20843937
DOI: 10.1136/bmj.c4543 -
BMJ (Clinical Research Ed.) Jan 2015To determine the optimal method for quantifying and monitoring overdiagnosis in cancer screening over time. (Review)
Review
OBJECTIVE
To determine the optimal method for quantifying and monitoring overdiagnosis in cancer screening over time.
DESIGN
Systematic review of primary research studies of any design that quantified overdiagnosis from screening for nine types of cancer. We used explicit criteria to critically appraise individual studies and assess strength of the body of evidence for each study design (double blinded review), and assessed the potential for each study design to accurately quantify and monitor overdiagnosis over time.
DATA SOURCES
PubMed and Embase up to 28 February 2014; hand searching of systematic reviews.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
English language studies of any design that quantified overdiagnosis for any of nine common cancers (prostate, breast, lung, colorectal, melanoma, bladder, renal, thyroid, and uterine); excluded case series, case reports, and reviews that only reported results of other studies.
RESULTS
52 studies met the inclusion criteria. We grouped studies into four methodological categories: (1) follow-up of a well designed randomized controlled trial (n=3), which has low risk of bias but may not be generalizable and is not suitable for monitoring; (2) pathological or imaging studies (n=8), drawing conclusions about overdiagnosis by examining biological characteristics of cancers, a simple design limited by the uncertain assumption that the measured characteristics are highly correlated with disease progression; (3) modeling studies (n=21), which can be done in a shorter time frame but require complex mathematical equations simulating the natural course of screen detected cancer, the fundamental unknown question; and (4) ecological and cohort studies (n=20), which are suitable for monitoring over time but are limited by a lack of agreed standards, by variable data quality, by inadequate follow-up time, and by the potential for population level confounders. Some ecological and cohort studies, however, have addressed these potential weaknesses in reasonable ways.
CONCLUSIONS
Well conducted ecological and cohort studies in multiple settings are the most appropriate approach for quantifying and monitoring overdiagnosis in cancer screening programs. To support this work, we need internationally agreed standards for ecological and cohort studies and a multinational team of unbiased researchers to perform ongoing analysis.
Topics: Cohort Studies; Early Detection of Cancer; Evidence-Based Medicine; Humans; Mass Screening; Neoplasms; Observation; Outcome Assessment, Health Care; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Time Factors
PubMed: 25569206
DOI: 10.1136/bmj.g7773 -
Revista Da Associacao Medica Brasileira... Mar 2018Considering the importance of screening for prostate cancer, the possibility of damage resulting from indiscriminate screening and the difficulty of disclosure and... (Review)
Review
OBJECTIVE
Considering the importance of screening for prostate cancer, the possibility of damage resulting from indiscriminate screening and the difficulty of disclosure and adherence to the main guidelines on the subject, we aimed to identify current guidelines, look for common approaches and establish a core of conducts.
METHOD
Systematic review of the literature on screening practice guidelines for prostate cancer searching the databases PubMed, Lilacs and Google Scholar and active search in the sites of several national health entities.
RESULTS
Twelve (12) guidelines were selected, whose analysis resulted in the identification of six common points of conduct, with the following minimum core of recommendations: (1) screening indication or not: must be individualized, and preceded by an informed decision; (2) tests used: PSA with or without rectal digital examination; (3) age at which initiate testing in men in general risk: 50-55 years; (4) age at which to initiate testing in men at increased risk: 40-45 years; (5) the interval between screening: annual or biennial; and (6) age at which to discontinue testing: 70 years-old or life expectancy less than 10 years.
CONCLUSION
Although there are differences between them, it was possible to establish a minimum core of conducts that may be useful in the daily practice of the physician.
Topics: Age of Onset; Early Detection of Cancer; Humans; Male; Mass Screening; Practice Guidelines as Topic; Prostate-Specific Antigen; Prostatic Neoplasms
PubMed: 29641784
DOI: 10.1590/1806-9282.64.03.290 -
Sleep Medicine Reviews Apr 2017The goal of this review was to identify, describe, and evaluate the existing multiple sleep disorders screening questionnaires for their comprehensiveness, brevity, and... (Review)
Review
The goal of this review was to identify, describe, and evaluate the existing multiple sleep disorders screening questionnaires for their comprehensiveness, brevity, and psychometric quality. A systematic review was conducted using Medline/PubMed, cumulative index to nursing & allied health literature, health and psychosocial instruments and the "grey literature". Search terms were "sleep disorders, screening, questionnaires, and psychometrics". The scope of the search was limited to English language articles for adult age groups from 1989 through 2015. Of the n = 2812 articles identified, most were assessment or treatment guideline reviews, topical reviews, and/or empirical articles. Seven of the articles described multiple sleep disorders screening instruments. Of the identified instruments, two questionnaires (the Holland sleep Disorders questionnaire and sleep-50) were evaluated as comprehensive and one questionnaire (the global sleep assessment questionnaire [GSAQ]) was judged to be both comprehensive and efficient. The GSAQ was found to cover four of the six core intrinsic disorders, sleep insufficiency, and daytime sequela with 11 questions. Accordingly, the GSAQ is the most suitable for application as a general sleep disorders screener. Additional work is required to validate this instrument in the context of primary care. Finally, the future development of multiple sleep disorders screening questionnaires should not only cover all six intrinsic sleep disorders but also acquire some basic demographic information (age, sex, body mass index, presence/absence of bed partner, work status and shift) and some limited data regarding sleep sufficiency and the daytime consequences of sleep disturbance.
Topics: Humans; Mass Screening; Primary Health Care; Psychometrics; Sleep Wake Disorders; Surveys and Questionnaires
PubMed: 27013458
DOI: 10.1016/j.smrv.2016.02.004 -
International Journal of Environmental... Nov 2022Developmental surveillance and screening is recommended for all children under five years of age, especially for those from at-risk populations such as First Nations... (Review)
Review
Developmental surveillance and screening is recommended for all children under five years of age, especially for those from at-risk populations such as First Nations children. No review to date has, however, evaluated the use of developmental screening tools with First Nations children. This review aimed to examine and synthesise the literature on developmental screening tools developed for, or used with, First Nations populations children aged five years or younger. A PRISMA-compliant systematic review was performed in the PsychInfo, PubMed, and Embase databases. Additional searches were also undertaken. In total 444 articles were identified and 13 were included in the final review. Findings indicated that several developmental screening tools have been administered with First Nations children. Most tools, however, have only been evaluated in one study. Results also found that no studies evaluated actions taken following positive screening results. More research evaluating the accuracy, acceptability, and feasibility of using developmental screeners with First Nations children is required before widespread implementation of developmental screening in clinical settings with First Nations children is recommended.
Topics: Child; Humans; Child, Preschool; Risk Factors; Databases, Factual; Data Management; PubMed; Mass Screening
PubMed: 36497697
DOI: 10.3390/ijerph192315627 -
BMC Psychiatry Feb 2022Cognitive disorders and dementia have an important effect on individual independence and orientation. According to the Alzheimer's Disease International (ADI) 75% of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cognitive disorders and dementia have an important effect on individual independence and orientation. According to the Alzheimer's Disease International (ADI) 75% of people with dementia are not diagnosed; this may be as high as 90% in some low- and middle-income countries. This systematic review and meta-analysis aimed to identify the test performance of screening tools and compare them pairwise. The findings of our study can support countries in planning to establish and care for mild cognitive impairment in primary health centers.
METHODS
Medline (PubMed), Scopus, Cochrane, Dare, All EBM Reviews, CRD (OVID), and Proquest were searched from 2012 to November 2021. The risk of bias was assessed through the QUADAS-2 instrument. Given the high heterogeneity between studies, a random-effects model was used to calculate the pooled effect sizes for diagnostic accuracy measures (sensitivity, specificity, and area under curve indices). I test was used for assessing heterogeneity and predefined subgroup analyses were performed using participants' age, country's income, and sample size of studies.
RESULTS
A systematic search identified 18,132 records, of which, 20 studies were included in the quality assessment, and six were included in quantitative analysis. None of the studies had examined the feasibility or efficiency of mass screening. According to a pairwise comparison, IQCODE, AD8 and GPCOG showed equal or better diagnostic performance relative to the MMSE in terms of sensitivity and specificity. The random-effect model for the MMSE showed the pooled sensitivity equal to 0.73 (95% CI 0.57-0.90), the pooled specificity equal to 0.83 (95% CI 0.75-0.90), and the pooled AUC equal to 0.88 (95% CI 0.83-0.93).
CONCLUSION
Several benefits have been attached to short tests making them a suitable choice for use in primary healthcare settings. Considering factors such as accuracy, time of application, ease of scoring, and utilization charges, tests such as IQCODE, AD8, and GPCOG or appropriate combination with counterpart tools seem to be good alternatives to the use of the MMSE in primary care.
Topics: Cognition Disorders; Cognitive Dysfunction; Dementia; Humans; Mass Screening; Primary Health Care
PubMed: 35139803
DOI: 10.1186/s12888-022-03730-8 -
Obesity (Silver Spring, Md.) Feb 2009Obese women are at an increased risk of death from cervical cancer, but the explanation for this is unknown. Through our systematic review, we sought to determine... (Comparative Study)
Comparative Study Meta-Analysis Review
Obese women are at an increased risk of death from cervical cancer, but the explanation for this is unknown. Through our systematic review, we sought to determine whether obesity is associated with cervical cancer screening and whether this association differs by race. We identified original articles evaluating the relationship between body weight and Papanicolaou (Pap) testing in the United States through electronic (PubMed, CINAHL, and the Cochrane Library) and manual searching. We excluded studies in special populations or those not written in English. Two reviewers sequentially extracted study data and independently extracted quality using standardized forms. A total of 4,132 citations yielded 11 relevant studies. Ten studies suggested an inverse association between obesity and cervical cancer screening. Compared to women with a normal BMI, the combined odds ratios (95% CI) for Pap testing were 0.91 (0.80-1.03), 0.81 (0.70-0.93), 0.75 (0.64-0.88), and 0.62 (0.55-0.69) for the overweight and class I, class II, and class III obesity categories, respectively. Three out of four studies that presented the results by race found this held true for white women, but no study found this for black women. In conclusion, obese women are less likely to report being screened for cervical cancer than their lean counterparts, and this does not hold true for black women. Less screening may partly explain the higher cervical cancer mortality seen in obese white women.
Topics: Black People; Female; Humans; Mass Screening; Obesity; Papanicolaou Test; United States; Uterine Cervical Neoplasms; Vaginal Smears; White People
PubMed: 18997682
DOI: 10.1038/oby.2008.480