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7505. Screening for cancer: advice for high-value care from the American College of Physicians.
Cancer screening is one approach to reducing cancer-related morbidity and mortality rates. Screening strategies vary in intensity. Higher-intensity strategies are not necessarily higher value. High-value strategies provide a degree of benefits that clearly justifies the harms and costs incurred; low-value screening provides limited or no benefits to justify the harms and costs. When cancer screening leads to benefits, an optimal intensity of screening maximizes value. Some aspects of screening practices, especially overuse and underuse, are low value.
7506. A value framework for cancer screening: advice for high-value care from the American College of Physicians.
Experts, professional societies, and consumer groups often recommend different strategies for cancer screening. These strategies vary in the intensity of their search for asymptomatic lesions and in their value. This article outlines a framework for thinking about the value of varying intensities of cancer screening. The authors conclude that increasing intensity beyond an optimal level leads to low-value screening and speculate about pressures that encourage overly intensive, low-value screening.
7507. Imaging Techniques for the Diagnosis of Hepatocellular Carcinoma: A Systematic Review and Meta-analysis.
作者: Roger Chou.;Carlos Cuevas.;Rongwei Fu.;Beth Devine.;Ngoc Wasson.;Alexander Ginsburg.;Bernadette Zakher.;Miranda Pappas.;Elaine Graham.;Sean D Sullivan.
来源: Ann Intern Med. 2015年162卷10期697-711页
Several imaging modalities are available for diagnosis of hepatocellular carcinoma (HCC).
7508. Metachronous hormonal syndromes in patients with pancreatic neuroendocrine tumors: a case-series study.
作者: Louis de Mestier.;Olivia Hentic.;Jérôme Cros.;Thomas Walter.;Guillaume Roquin.;Hedia Brixi.;Catherine Lombard-Bohas.;Pascal Hammel.;Marie-Danièle Diebold.;Anne Couvelard.;Philippe Ruszniewski.;Guillaume Cadiot.
来源: Ann Intern Med. 2015年162卷10期682-9页
Pancreatic neuroendocrine tumors (PNETs) may evolve and cause hormonal hypersecretion-related symptoms that were not present at the initial diagnosis, termed metachronous hormonal syndromes (MHSs). Their setting, characteristics, and outcomes are not well-described.
7509. Identifying women with dense breasts at high risk for interval cancer: a cohort study.
作者: Karla Kerlikowske.;Weiwei Zhu.;Anna N A Tosteson.;Brian L Sprague.;Jeffrey A Tice.;Constance D Lehman.;Diana L Miglioretti.; .
来源: Ann Intern Med. 2015年162卷10期673-81页
Twenty-one states have laws requiring that women be notified if they have dense breasts and that they be advised to discuss supplemental imaging with their provider.
7514. Differential diagnosis of illness in travelers arriving from Sierra Leone, Liberia, or Guinea: a cross-sectional study from the GeoSentinel Surveillance Network.
作者: Andrea K Boggild.;Douglas H Esposito.;Phyllis E Kozarsky.;Vernon Ansdell.;Nicholas J Beeching.;Daniel Campion.;Francesco Castelli.;Eric Caumes.;Francois Chappuis.;Jakob P Cramer.;Effrossyni Gkrania-Klotsas.;Martin P Grobusch.;Stefan H F Hagmann.;Noreen A Hynes.;Poh Lian Lim.;Rogelio López-Vélez.;Denis J M Malvy.;Marc Mendelson.;Philippe Parola.;Mark J Sotir.;Henry M Wu.;Davidson H Hamer.; .
来源: Ann Intern Med. 2015年162卷11期757-64页
The largest-ever outbreak of Ebola virus disease (EVD), ongoing in West Africa since late 2013, has led to export of cases to Europe and North America. Clinicians encountering ill travelers arriving from countries with widespread Ebola virus transmission must be aware of alternate diagnoses associated with fever and other nonspecific symptoms.
7515. Sexual Orientation Identity Disparities in Awareness and Initiation of the Human Papillomavirus Vaccine Among U.S. Women and Girls: A National Survey.
作者: Madina Agénor.;Sarah Peitzmeier.;Allegra R Gordon.;Sebastien Haneuse.;Jennifer E Potter.;S Bryn Austin.
来源: Ann Intern Med. 2015年163卷2期99-106页
Lesbians and bisexual women are at risk for human papillomavirus (HPV) infection from female and male sexual partners.
7516. Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians.
In this position paper, the American College of Physicians examines the health disparities experienced by the lesbian, gay, bisexual, and transgender (LGBT) community and makes a series of recommendations to achieve equity for LGBT individuals in the health care system. These recommendations include enhancing physician understanding of how to provide culturally and clinically competent care for LGBT individuals, addressing environmental and social factors that can affect their mental and physical well-being, and supporting further research into understanding their unique health needs.
7517. Characteristics and Clinical Management of a Cluster of 3 Patients With Ebola Virus Disease, Including the First Domestically Acquired Cases in the United States.
作者: Allison M Liddell.;Richard T Davey.;Aneesh K Mehta.;Jay B Varkey.;Colleen S Kraft.;Gebre K Tseggay.;Oghenetega Badidi.;Andrew C Faust.;Katia V Brown.;Anthony F Suffredini.;Kevin Barrett.;Mark J Wolcott.;Vincent C Marconi.;G Marshall Lyon.;Gary L Weinstein.;Kenney Weinmeister.;Shelby Sutton.;Munir Hazbun.;César G Albariño.;Zachary Reed.;Debi Cannon.;Ute Ströher.;Mark Feldman.;Bruce S Ribner.;H Clifford Lane.;Anthony S Fauci.;Timothy M Uyeki.
来源: Ann Intern Med. 2015年163卷2期81-90页
More than 26,000 cases of Ebola virus disease (EVD) have been reported in western Africa, with high mortality. Several patients have been medically evacuated to hospitals in the United States and Europe. Detailed clinical data are limited on the clinical course and management of patients with EVD outside western Africa.
7519. In the Clinic. Deep venous thrombosis.
This issue provides a clinical overview of deep venous thrombosis, focusing on prevention, diagnosis, treatment, and patient information. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of science writers and physician writers. Editorial consultants from ACP Smart Medicine and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult http://smartmedicine.acponline.org, http://mksap.acponline.org, and other resources referenced in each issue of In the Clinic.
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