Study Reference Journal Study Design Study Population (n) Findings Framework Research Priority 1: Define the scope of Overdiagnosis and Overtreatment in Medicine Framework Research Priority 2: Identify the most important drivers of overuse Framework Research Priority 3: Measure the Impact of Overuse Framework Research Priority 4: Understand the Impact of Choosing Wisely and other initiatives on clinical practice and patient outcomes
Lee et al. (2016) [18]
Academic Radiology Commentary N/A Highlighted the methodological limitations of overdiagnosis research (i.e., counterfactual incidence, insufficient follow-up time, and trial design limitations). Modeling could better predict outcomes to inform recommendations and policies. X
Schmidt et al. (2016) [19]
Journal of American Medical Association Internal Medicine Case study 60 year old male patient (1) Explored the Overdiagnosis of Coronary Artery Disease Detected by Coronary Computed Tomography Angiography. Authors expressed need to implement Choosing Wisely protocol for management of diagnosis. X X
Welch et al. (2016)
[20]
New England Journal Of Medicine Secondary data analysis Women 40 years or older with breast cancer (10% of US Population) While rate of detection of large tumors fell after the introduction of mammography as a screening technique, technique also resulted in increased detection of small tumors. Overdiagnosis of preliminary screening meant women were more likely to have breast cancer that was
A recent systematic review of observational data (6 studies) found that the total mortality rate in angina patients was 2.8% to 6.6% per annum(121). At present it is thought that stable angina does not cause permanent myocardial damage. However prompt diagnosis and treatment is important to prevent further complications. Initiation of pharmacological intervention has been shown to retard plaque disease progression and to stabilise the surface endothelium(131).
Masson devotes a more emotional appeal throughout the article, rather than offering confirmation to display that mammograms are not beneficial. She expresses reflection to show the reader her perspective and even contradicts herself in one aspect stating “If I should happen to discover a lump in my breast, I’ll have it evaluated. I’m not opposed to having a diagnostic mammogram” (Masson, 2010). This statement shows weakness within her argument and recognizes that there is potential in mammogram screening. Although relying on mammography is not the only primary diagnostic tool, it can however assist in the initial diagnostic process.
Facilities, performing coronary CTA, should develop and adhere to evidence based coronary CTA protocols for optimal, high quality, cost-effective, patient-centered care. A comprehensive review of the literature was performed using CINAHL, PubMed, MEDLINE, and Medscape search engines, and with the terms ?coronary CTA?, ?protocols?, ?guidelines?, ?radiation?, ?contrast?, ?beta-blockers?, and ?radiology nursing?.
The Author reports that the new recommended age for mammograms, by the United States Preventative Services Task Force, has changed from 50 to 40 to reduce the harm from over screening and overtreatment. It also reports that self-breast examinations are no longer recommended on a regular basis. This recommendation comes from evidence that there are no major benefits of early screenings and that only “one cancer death is prevented for every 1,904 women” screened, age 40 to 49. Conversely, there is evidence that frequent early screenings can lead to overtreatment
In today’s society, women are not getting their mammograms done because they feel they are not necessary or because they are afraid of the results of the mammograms. Since women do not get their mammograms done, they are exposed to breast cancer. According to the National Cancer Institute, women who get mammograms, reduce about “15% to 20% in mortality from breast cancer” (“National Cancer Institute” 1). If women would increase the rate of getting mammograms, there will be less deaths in women.
Mammograms are breast cancer screenings and are of great importance since they detect if indeed a malignant tumor is present and if so what stage it is in (Stephan, 2010). Cancers can be detected at stages I, II, or IIA (Haas et al., 2008).
Many people think that having a yearly mammogram is a waste time and that it 's not a solution to breast cancer. One hundred thousand women turn into their 30s lives could be saved by annual screening. But others might not be safe those who turn forty. For every 1,000 women who have a mammogram screening only 100 of them are recalled to get more mammograms or ultrasound images, 20 of them are recommended for a needle biopsy, the other 5 are diagnosed with cancer. "About 40,290 women in the U.S. are expected to die in 2015 from breast cancer though death rates have been decreasing since 1989"("U.S. Breast Cancer...). The number of deaths was 21.9 per 100,00 women per year. These are the rates age-adjusted and based on 2008-2012 cases and
The following summary is an updated case study of a 47 year old male patient, Jim who was diagnosed with Coronary Artery Disease. The patient did receive information on what CAD is and was informed that test were needed to fully diagnose and be evaluated for underlying conditions (high blood pressure, high blood cholesterol levels, diabetes and blockage. I will discuss the type of test needed for this condition and tests for any underlying conditions that are related to this disease. The type of treatment needed to control and lower his risk factor. I will also give the patient information about complementary and alternative medicine so the patient will be well informed about different types of treatment. The patient will be informed about the prognosis of the disease, and the options that the patient has to succeed in the changes in his lifestyle that are needed.
Coronary Artery Disease, also known as CAD, is the most common form of heart disease. (Heart and Stroke Foundation, 2009) Coronary Artery Disease obstructs the blood flow in vessels that provides blood to the heart which is caused by the buildup of plaque on the artery walls. (Rogers, 2011, p.87) (Heart and Stroke Foundation, 2009) Plaque is a yellow substance that consists of fat substances, like cholesterol, and narrows or clogs the arteries which prevents blood flow. (Heart and Stroke Foundation, 2009) Plaque can build up in any artery but usually favors large and medium sized arteries. (Heart and Stroke Foundation, 2009)
Currently mammography and ultrasound are basic imaging techniques for detection and localization of breast tumor. Breast Ultrasound is a typically painless medical test that uses reflected sound waves for further evaluation of a breast abnormality or a specific area seen on mammography. Ultrasound can locate and measure abnormalities or changes to determine if a breast lump is solid or filled with fluid. A mammogram is an x-ray of the breast which may find tumors that are too small to feel. Women aged 40 to 74 years should have annual screening mammograms to lower chance of dying from breast cancer(2,15).Mammograms are less likely to find breast tumors in women younger than 50 years. This may
Three-quarters of all breast cancer patients are not in any of the groups considered at increased risk for breast cancer, indicating that not all risk factors are understood. As a result, doctors recommend that every woman should familiarize herself with the techniques for monthly breast self-examination. X-ray examination of the breasts, a technique called mammography, can detect tumors before they are large enough to be felt and increase the odds for successful treatment. The American Cancer Society recommends that women over age 40
In addition to the risks associated with coronary CTA, there are some contraindications to the procedure which include pregnancy, severe anaphylactic contrast reaction, unable to comply with the scanning instructions (such as inability to hold long breath-hold), renal insufficiency, body mass index <41%, and clinically unstable patients (Sabarudin & Sun, 2013). The radiology nurse’s role in vital in identification of procedural contraindications, and contraindications for β-blocker administration.
Coronary artery disease (CAD) is caused by fatty buildup in the arteries of the heart. Your arteries are made to carry oxygen infused blood to your heart and other parts of your body if it is filled up with plaque, which is the fatty substance that clogs and blocks up the arteries. If it gets clogged enough to where your heart is not receiving fresh oxygen, you could have a heart attack that could cause very serious damage to your body and could even kill you. When you are younger, you can begin to grow plaque in your blood vessels from not eating right and not exercising regularly. When your arteries are being filled up with plaque they become more narrow and harder for blood to get through as easily as it is supposed to be. When you have
For example, around 6-10% of mammogram results are false positives, meaning the images show what appear to be tumors but are actually cysts or harmless tissues. This estimate may be higher in younger women, as young women have denser breast tissues which may be difficult to scan as compared to women over 50, whose breasts are mainly composed of fatty tissues (Geraci, Gordon, Gower, Harrar & Paturel, 2008). Screening for dementia
Through these screenings, prognosis improves when breast cancers are discovered in their earlier stages. Better access to health care for all citizens owing to Singapore’s economic growth and urban development too, allowed for earlier detection (Jara-Lazaro, Thilagaratnam, & Tan, 2010). Life expectancy of breast cancer patients hence have improved quite spectacularly with early detection and successful treatments that delayed cancer deaths (Beesley et al., 2008). This means that more people have lived with and survived breast cancer (Jara-Lazaro, et al., 2010).