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475. 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.
476. 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.
477. 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).
478. 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.
479. 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.
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