Risultati per: Nuovo test per lo screening del cancro alla prostata

Annals of Internal Medicine, Ahead of Print.

In Reply The USPSTF prioritized reviewing the evidence on screening and supplementation for iron deficiency and iron deficiency anemia during pregnancy because of the association between iron deficiency and adverse maternal and newborn health outcomes, although certain factors (eg, baseline nutritional status) may affect this relationship.

To the Editor The US Preventive Services Task Force (USPSTF) recently released a recommendation restating that “the current evidence is insufficient to assess the balance of benefits and harms of screening for iron deficiency and iron deficiency anemia in pregnant persons to prevent adverse maternal and infant health outcomes.” We are concerned that if clinical judgment regarding whether to screen for iron deficiency and iron deficiency anemia and whether to provide routine iron supplementation during pregnancy is not done in a liberal fashion, serious consequences may arise for female patients who have complex blood group antigen constellations. Similarly, screening for iron deficiency during pregnancy may be important for individuals who do not want to receive donor blood.

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Introduction
Anxiety problems are prevalent in childhood and, without intervention, can persist into adulthood. Effective evidence-based interventions for childhood anxiety disorders exist, specifically cognitive–behavioural therapy (CBT) in a range of formats. However, only a small proportion of children successfully access and receive treatment. Conducting mental health screening in schools and integrating evidence-based interventions for childhood anxiety problems may be an effective way to ensure support reaches children in need. The Identifying Child Anxiety Through Schools—Identification to Intervention (iCATS i2i) trial involves screening for childhood anxiety problems and offering a brief online parent-led CBT intervention. This paper presents the protocol for the process evaluation of the iCATS i2i trial, which aims to examine the implementation and acceptability of the study procedures, the mechanisms of change and whether any external factors had an impact on procedure engagement or delivery.

Methods and analysis
This process evaluation will use both quantitative and qualitative methods to evaluate the implementation and acceptability of and barriers/facilitators to engagement and delivery of the iCATS screening/intervention procedures. Quantitative data sources will include opt-out and completion rates of baseline measures and usage analytics extracted from the online intervention platform. Qualitative interviews will be conducted with children, parents, school staff, iCATS i2i clinicians and researchers delivering study procedures. The Medical Research Council framework for process evaluations will guide study design and analysis.

Ethics and dissemination
This study has received ethical approval from the University of Oxford Research Ethics Committee (R66068_RE003). Findings from the study will be disseminated via peer-reviewed publications in academic journals, conferences, digital and social media platforms and stakeholder meetings.

Trial registration
ISRCTN76119074.

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Our review highlights the potential for the use of AI algorithms applied to retina images, particularly CFP, to screen, predict, or diagnose the various microvascular and macrovascular complications of diabetes. However, we identified few studies with longitudinal data and a paucity of randomized control trials, reflecting a gap between the development of AI algorithms and real-world implementation and translational studies.

Objective
The aim of this study was to estimate the total national direct cost of breast cancer screening from 2019 to 2022 and project the total national cost and average lifetime cost of screening per woman for three current guidelines.

Design
We estimated the national cost of screening from 2019 to 2022, and per cancer detected in 2022, using real-world data on the number of mammograms performed per year. We also projected the national cost of screening using life table modelling for three guidelines: 2021/2023 American College of Radiology (ACR), 2023 American Cancer Society (ACS) and 2024 United States Preventative Services Task Force (USPSTF). The average lifetime cost to screen one woman until age 74 years with each guideline was also estimated. The Optum Labs Data Warehouse was used to estimate commercial and Medicare costs and recall rates. Sensitivity analyses were used to estimate uncertainty and determine which inputs had the largest impact on total national costs.

Setting
This study was conducted for the USA.

Participants
Women eligible for breast cancer screening.

Interventions
Digital mammograms (2D) or digital breast tomosynthesis (3D) and/or MRI.

Primary outcome measure
Total national cost of screening calculated as the sum of screening and recall costs. Average lifetime cost of screening per woman until 74 years.

Results
Nationally, screening cost approximately US$11 billion (B) per year from 2019 to 2022 with approximately 37% of eligible women screened each year. In 2022, screening cost US$55 471 per 3D-detected and US$44 000 per 2D-detected invasive or ductal carcinoma in situ case. Using target yearly participation rates of 54%–78% by age of women, the projected cost of screening was US$30B for ACR, US$18B for ACS and US$8B for USPSTF guidelines. The average lifetime cost to screen an average-risk woman was: US$13 416 for ACR, US$7946 for ACS and US$6931 for USPSTF. Participation rates, the proportion of women with a lifetime risk >20% and commercial MRI and 3D costs had the largest impact on total costs.

Conclusion
The cost of screening varies significantly by guideline (US$8B–US$30B) and was most influenced by participation rates, high-risk population proportions and technology costs. Future work can investigate whether risk-based screening strategies being tested in ongoing clinical trials can reduce national screening costs while improving outcomes.Cite Now

Mailed outreach to encourage HCC screening in patients with cirrhosis dominates usual care and should be considered for implementation in routine practice.

Circulation, Volume 151, Issue 7, Page 508-510, February 18, 2025.

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Cruciale per questa neoplasia gravata dalla diagnosi tardiva