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Articles 1 - 10 of 10
Full-Text Articles in Analytical, Diagnostic and Therapeutic Techniques and Equipment
A Systematic Review Of Studies Comparing Diagnostic Clinical Prediction Rules With Clinical Judgement, Sharon Sanders, Jenny A. Doust, Paul Glasziou
A Systematic Review Of Studies Comparing Diagnostic Clinical Prediction Rules With Clinical Judgement, Sharon Sanders, Jenny A. Doust, Paul Glasziou
Jenny Doust
Diagnostic clinical prediction rules (CPRs) are developed to improve diagnosis or decrease diagnostic testing. Whether, and in what situations diagnostic CPRs improve upon clinical judgment is unclear. We searched MEDLINE, Embase and CINAHL, with supplementary citation and reference checking for studies comparing CPRs and clinical judgment against a current objective reference standard. We report 1) the proportion of study participants classified as not having disease who hence may avoid further testing and or treatment and 2) the proportion, among those classified as not having disease, who do (missed diagnoses) by both approaches. 31 studies of 13 medical conditions were included, …
Political Drive To Screen For Pre-Dementia: Not Evidence Based And Ignores The Harms Of Diagnosis, David Le Couteur, Jenny A. Doust, Helen Creasey, Carol Brayne
Political Drive To Screen For Pre-Dementia: Not Evidence Based And Ignores The Harms Of Diagnosis, David Le Couteur, Jenny A. Doust, Helen Creasey, Carol Brayne
Jenny Doust
Current policy in many countries is aimed at increasing the rates of diagnosis of dementia and cognitive impairment.1 2 3 This policy drive has been accompanied by research into early detection of dementia, including preclinical identification of underlying neurobiology that might later be associated with dementia.4 Although the clinical features of people with established dementia are unmistakable,5 6 the ability of these preclinical features to predict future disease is less clear. Nevertheless, the belief that there is value in screening for “pre-dementia” or mild cognitive impairment is creeping into clinical practice, with the resulting overdiagnosis having potential adverse consequences for …
Development And Validation Of The Emergency Department Assessment Of Chest Pain Score And 2h Accelerated Diagnostic Protocol, Martin Than, Dylan Flaws, Sharon Sanders, Jenny Doust, Paul Glasziou, Jeffrey Kline, Sally Aldous, Richard Troughton, Christopher Reid, William Parsonage, Christopher Frampton, Jaimi Greenslade, Joanne Deely, Erik Hess, Amr Sadiq, Rose Singleton, Rosie Shopland, Laura Vercoe, Morgana Woolhouse-Williams, Michael Ardagh, P. Bossuyt, Laura Bannister, Louise Cullen
Development And Validation Of The Emergency Department Assessment Of Chest Pain Score And 2h Accelerated Diagnostic Protocol, Martin Than, Dylan Flaws, Sharon Sanders, Jenny Doust, Paul Glasziou, Jeffrey Kline, Sally Aldous, Richard Troughton, Christopher Reid, William Parsonage, Christopher Frampton, Jaimi Greenslade, Joanne Deely, Erik Hess, Amr Sadiq, Rose Singleton, Rosie Shopland, Laura Vercoe, Morgana Woolhouse-Williams, Michael Ardagh, P. Bossuyt, Laura Bannister, Louise Cullen
Jenny Doust
Objective: Risk scores and accelerated diagnostic protocols can identify chest pain patients with low risk of major adverse cardiac event who could be discharged early from the ED, saving time and costs. We aimed to derive and validate a chest pain score and accelerated diagnostic protocol (ADP) that could safely increase the proportion of patients suitable for early discharge. Methods: Logistic regression identified statistical predictors for major adverse cardiac events in a derivation cohort. Statistical coefficients were converted to whole numbers to create a score. Clinician feedback was used to improve the clinical plausibility and the usability of the final …
Expanding Disease Definitions In Guidelines And Expert Panel Ties To Industry: A Cross-Sectional Study Of Common Conditions In The United State, Ray Moynihan, Georga Cooke, Jenny Doust, Lisa Bero, Suzanne Hill, Paul Glasziou
Expanding Disease Definitions In Guidelines And Expert Panel Ties To Industry: A Cross-Sectional Study Of Common Conditions In The United State, Ray Moynihan, Georga Cooke, Jenny Doust, Lisa Bero, Suzanne Hill, Paul Glasziou
Jenny Doust
Financial ties between health professionals and industry may unduly influence professional judgments and some researchers have suggested that widening disease definitions may be one driver of over-diagnosis, bringing potentially unnecessary labeling and harm. We aimed to identify guidelines in which disease definitions were changed, to assess whether any proposed changes would increase the numbers of individuals considered to have the disease, whether potential harms of expanding disease definitions were investigated, and the extent of members' industry ties.
Preventing Overdiagnosis: How To Stop Harming The Healthy, Ray Moynihan, Jenny Doust, David Henry
Preventing Overdiagnosis: How To Stop Harming The Healthy, Ray Moynihan, Jenny Doust, David Henry
Jenny Doust
Medicine’s much hailed ability to help the sick is fast being challenged by its propensity to harm the healthy. A burgeoning scientific literature is fuelling public concerns that too many people are being overdosed, overtreated, and overdiagnosed. Screening programmes are detecting early cancers that will never cause symptoms or death, sensitive diagnostic technologies identify “abnormalities” so tiny they will remain benign, while widening disease definitions mean people at ever lower risks receive permanent medical labels and lifelong treatments that will fail to benefit many of them. With estimates that more than $200bn (£128bn; €160bn) may be wasted on unnecessary treatment …
Development And Initial Validation Of A Simple Clinical Decision Tool To Predict The Presence Of Heart Failure In Primary Care: The Mice (Male, Infarction, Crepitations, Edema) Rule, Andrea Roalfe, Jonathan Mant, Jenny Doust, Pelham Barton, Martin Cowie, Paul Glasziou, David Mant, Richard Mcmanus, Roger Holder, Jonathon Deeks, Robert Doughty, Arno Hoes, Kate Fletcher, F.D.Richard Hobbs
Development And Initial Validation Of A Simple Clinical Decision Tool To Predict The Presence Of Heart Failure In Primary Care: The Mice (Male, Infarction, Crepitations, Edema) Rule, Andrea Roalfe, Jonathan Mant, Jenny Doust, Pelham Barton, Martin Cowie, Paul Glasziou, David Mant, Richard Mcmanus, Roger Holder, Jonathon Deeks, Robert Doughty, Arno Hoes, Kate Fletcher, F.D.Richard Hobbs
Jenny Doust
Aims: Diagnosis of heart failure in primary care is often inaccurate, and access to and use of echocardiography is suboptimal. This study aimed to develop and provisionally validate a clinical prediction rule to optimize referral for echocardiography of people identified in primary care with suspected heart failure. Methods and results: A systematic review identified studies of diagnosis of heart failure set in primary care. The individual patient data for five of these studies were obtained. Logistic regression models to predict heart failure were developed on one of the data sets and validated on the others using area under the receiver …
Diagnosis Of Heart Failure In Primary Care, F. D. R. Hobbs, Jenny Doust, Jonathan Mant, Martin R. Cowie
Diagnosis Of Heart Failure In Primary Care, F. D. R. Hobbs, Jenny Doust, Jonathan Mant, Martin R. Cowie
Jenny Doust
Extract: Heart failure is a syndrome resulting from a structural or functional cardiac disorder. For a diagnosis of heart failure to be made, there should be symptoms or signs, such as breathlessness, effort intolerance or fluid retention, together with objective evidence of cardiac dysfunction. Heart failure is an increasingly important chronic disease syndrome, associated with poor prognosis, poor quality of life for patients, and high healthcare costs. In the general population, where all grades of heart failure are represented, 5 year mortality is around 42%; however, where the diagnosis is established during a hospital admission, 5 year mortality is between …
Presenting A Simplified Assistant Tool For Breast Cancer Diagnosis In Mammography To Radiologists, Ping Zhang, Jenny Doust, Kuldeep Kumar
Presenting A Simplified Assistant Tool For Breast Cancer Diagnosis In Mammography To Radiologists, Ping Zhang, Jenny Doust, Kuldeep Kumar
Jenny Doust
This paper proposes a method to simplify a computational model from logistic regression for clinical use without computer. The model was built using human interpreted features including some BI-RADS standardized features for diagnosing the malignant masses. It was compared with the diagnosis using only assessment categorization from BI-RADS. The research aims at assisting radiologists to diagnose the malignancy of breast cancer in a way without using automated computer aided diagnosis system.
Diagnosis In General Practice: Using Probabilistic Reasoning, Jenny Doust
Diagnosis In General Practice: Using Probabilistic Reasoning, Jenny Doust
Jenny Doust
Diagnostic tests—whether clinical signs, imaging, or laboratory tests—are imperfect: there is always a possibility that test results are inaccurate and our diagnosis is wrong. However, we need to make decisions about whether to treat or not to treat patients, and so we need to feel confident that our diagnosis is above a certain threshold before we decide to treat a patient and below a certain threshold if we decide to withhold treatment. The threshold depends on the disease and the potential harms and benefits of treating or not treating patients. Unless we have clear strategies to cope with the uncertainties …
Acute Respiratory Infections, Sharon Sanders, Jenny Doust, Chris Del Mar
Acute Respiratory Infections, Sharon Sanders, Jenny Doust, Chris Del Mar
Jenny Doust
Extract: Acute respiratory infections may be classified in several different ways: by their symptoms (fever, sore throat, cough, ear pain, runny nose); by their clinical manifestations (coryza, pharyngitis, tonsillitis, epiglottitis, otitis media, influenza, bronchitis, pneumonia); or by causative organism. Furthermore, their symptoms and sometimes the whole clinical picture may be shared by conditions that are not infections (asthma, allergic rhinitis). Some of this complexity is shown in Figure 46.1. Elucidating the exact location or responsible organism is usually clinically unhelpful. In this chapter, we focus on diagnostic questions that have the greatest impact on the patient with an acute respiratory …