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Identifying melanoma among benign simulators - Is there a role for deep learning convolutional neural networks? (MelSim Study).

IMPORTANCE: Early detection of cutaneous melanoma (CM) is crucial for patient survival, yet avoiding overdiagnosis remains essential. Differentiating CM from benign melanoma simulators (MelSim) is challenging due to overlapping features. Deep learning convolutional neural networks (DL-CNNs) have demonstrated dermatologist-level accuracy in identifying CM. We hypothesized that support from DL-CNN could increase dermatologists' accuracy in differentiating CM from MelSim. METHODS: This cross-sectional reader study analyzed the diagnostic performance of a DL-CNN and 27 dermatologists for 200 skin…

To biopsy or not biopsy, that is the question - PI-RADS 3 prostate lesions - validation of clinical and radiological parameters for biopsy decision-making.

OBJECTIVES: Multiparametric MRI (mpMRI) enhances prostate cancer (PCa) detection, especially when combined with targeted or MRI–ultrasound f … uideline recommendations. A personalized approach is recommended to balance the risks of under- and overdiagnosis in managing PI-RADS 3 lesions.

Оптическая нерва как новая диагностическая граница в множестве склероза: как оценка мультимодальных критериев 2024 года для предыдущего диагноза.

Пересмотренные критерии 2024 года McDonald признают зрительный нерв в качестве пятого топографического места для распространения в космосе (DIS), в связи с чем возникают критические вопросы, касающиеся его диагностических и технических требований. Чтобы проанализировать это новое включение, мы проводим целенаправленный обзор и иллюстрируем его клиническое значение в серии из трех пациентов, где оптическая нервозная экспертиза имела решающее значение для диагностики. Мы анализируем практическую реализацию ключевых диагностических инструментов, включая оптическо-совместимую томографию (OCT) (опр

Совпадение в аннотации оригинала
The revised 2024 McDonald criteria recognize the optic nerve as a fifth topographical location for dissemination in space (DIS), raising cri … uation, but also highlighting the critical need for careful exclusion of mimics, vigilance to avoid overdiagnosis, and the necessity of standardized acquisition protocols and robust normative databases for generalizing this approach.

Prostate Cancers in the Prostate-specific Antigen Interval of 1.8-3 ng/ml: Results from the Göteborg-2 Prostate Cancer Screening Trial.

BACKGROUND AND OBJECTIVE: Magnetic resonance imaging(MRI) and targeted biopsies reduce overdiagnosis of prostate cancer(PC). It is uncertain how this strategy performs for low PSA levels. The objective was to investigate the PI-RADS distribution, frequency and characteristics of screen-detected PC with PSA of 1.8-<3ng/ml and 3-<10ng/ml. METHODS: In the population-based Göteborg-2 screening study, 17 974 men choose to participate by having a PSA(2015-2020). One-third of the participants(n=6006) were randomized to Arm 3, men with a PSA ≥1.8ng/ml were recommended MRI. Men with positive MRI(PI-RA…

Prospective Validation Study of a Novel Integrated Pathway Based on Clinical Features, Magnetic Resonance Imaging Biomarkers, and MicroRNAs for Early Detection of Prostate Cancer.

BACKGROUND: Prostate cancer (PCa) is the most diagnosed cancer in men, with an increasing need to integrate noninvasive imaging and circulat … rate patient allocation to biopsy and patients' stratification into risk group categories, reducing overdiagnosis and overtreatment of clinically insignificant PCa.

Portosinusoidal Vascular Disorder: A Heretofore Unrecognized Manifestation of Sickle Cell Disease?

Portosinusoidal vascular disorder (PSVD) is a recently proposed histopathologic entity that encompasses a spectrum of often subtle hepatic m … ed clinical surveillance for portal hypertension and other complications. While subtle and prone to overdiagnosis, the features of PSVD should be carefully considered when interpreting liver biopsies from patients with sickle cell disease.

Trends in Prostate Specific Antigen (PSA) testing and prostate cancer incidence and mortality in Australia: A critical analysis.

BACKGROUND: Population trends in PSA testing and prostate cancer incidence do not perfectly correspond. We aimed to better understand relati … s in mortality rates were many fold smaller than the increases in incidence, suggesting substantial overdiagnosis of prostate cancer after introduction of PSA testing.

Invasion with Toxoplasma gondii can promote pneumocystis pneumonia in individuals with HIV/AIDS.

Pulmonary pathology is common in HIV-infected individuals, but the possible role of the parasitic protist Toxoplasma gondii (Nicolle et Manc … n can be caused by certain synergism between T. gondii and Pneumocystis jirovecii and in some cases overdiagnosis pneumocystis pneumonia due to undiagnosed toxoplasmosis pneumonia.

Cervical Spine Fractures: Who Really Needs CT Angiography?

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Compare a novel two-step algorithm for indicating a computed tomography angiography (CTA) in the setting of a cervical spine fracture with established gold standard criteria. SUMMARY OF BACKGROUND DATA: As CTA permits the rapid detection of blunt cerebrovascular injuries (BCVI), screening criteria for its use have broadened. However, more recent work warns of the potential for the overdiagnosis of BCVI, which must be considered with the adoption of broad criteria. METHODS: A novel two-step metric for indicating CTA screening was compared …

Plasma Free Cortisol in States of Normal and Altered Binding Globulins: Implications for Adrenal Insufficiency Diagnosis.

CONTEXT: Accurate diagnosis of adrenal insufficiency is critical because there are risks associated with overdiagnosis and underdiagnosis. Data using liquid chromatography tandem mass spectrometry (LC/MS/MS) free cortisol (FC) assays in states of high or low cortisol-binding globulin (CBG) levels, including cirrhosis, critical illness, and oral estrogen use, are needed. DESIGN: Cross-sectional. OBJECTIVE: Determine the relationship between CBG and albumin as well as total cortisol (TC) and FC in states of normal and abnormal CBG. Establish the FC level by LC/MS/MS that best predicts TC of <1…

The role of carboxy-terminal cross-linking telopeptide of type I collagen, dual x-ray absorptiometry bone strain and Romberg test in a new osteoporotic fracture risk evaluation: A proposal from an observational study.

The consolidated way of diagnosing and treating osteoporosis in order to prevent fragility fractures has recently been questioned by some papers, which complained of overdiagnosis and consequent overtreatment of this pathology with underestimating other causes of the fragility fractures, like falls. A new clinical approach is proposed for identifying the subgroup of patients prone to fragility fractures. This retrospective observational study was conducted from January to June 2015 at the Nuclear Medicine-Bone Metabolic Unit of the of the Fondazione IRCCS Ca' Granda, Milan, Italy. An Italian p…

HPV RNA in situ hybridization can inform cervical cytology-histology correlation.

BACKGROUND: In situ hybridization for human papillomavirus (HPV) messenger RNA (HPV RNA ISH) recently was introduced as an ancillary tool in … n identified on cytology has been sampled. Performing RNA ISH on biopsies decreases histologic LSIL overdiagnosis, and potentially can prompt further sampling when there is cytology-histology discordance. Cancer (Cancer Cytopathol) 2018. © 2018 American Cancer Society.

Watch and Wait Management of Inactive Cystic Echinococcosis - Does the Path to Inactivity Matter - Analysis of a Prospective Patient Cohort.

BACKGROUND: Overdiagnosis and overtreatment are rarely discussed in the context of NTDs despite their relevance for patients under the care of health services with limited resources where the risks of therapy induced complications are often disproportionate to the benefit. The advantages of cyst staging-based management of patients with cystic echinococcosis (CE) are not yet fully explored. Questions are: Do inactive cysts (CE 4 and CE 5) need treatment and is there a difference between cysts which reach CE4 and CE5 naturally or by benzimidazole therapy? METHODOLOGY/PRINCIPAL FINDINGS: Analys…

Diagnostic accuracy of developmental screening in primary care at the 18-month health supervision visit: a cross-sectional study.

BACKGROUND: Communication delays are often the first presenting problem in infants with a range of developmental disabilities. Our objective … unication delays, respectively. INTERPRETATION: The low specificity of the 1+NDDS flag may lead to overdiagnosis, and the low sensitivity of the 2+NDDS flag may lead to underdiagnosis, suggesting that infants who could benefit from early intervention may not be identified. The Nipissing District Developmental Screen does not have adequate characteristics to ac …

Requirement for age-specific peak cortisol responses to insulin-induced hypoglycaemia in children.

OBJECTIVE: Based on adult data, a peak cortisol response ≥500 nmol/l to insulin-induced hypoglycaemia constitutes a normal. Age-specific ref … e of a single peak cortisol threshold in children of all ages is not appropriate and will result in overdiagnosis of adrenal insufficiency in adolescents.

Utility of left bundle branch block as a diagnostic criterion for acute myocardial infarction.

The clinical utility of new or "presumably new" left bundle branch block (LBBB) as an electrocardiographic criterion equivalent to ST-segment elevation myocardial infarction in contemporary practice is not well established. The aim of this study was to investigate the hypothesis that new or presumably new LBBB in symptomatic patients frequently leads to an overdiagnosis of acute myocardial infarction (AMI). A retrospective analysis of data from consecutive patients in the Mayo Clinic's ST-segment elevation myocardial infarction network from July 2004 to August 2009 was conducted among 892 pati…

Clinical features of pyoderma gangrenosum and current diagnostic trends.

BACKGROUND: The diagnosis of pyoderma gangrenosum (PG) can be exceedingly difficult, and misdiagnosis can potentially yield serious conseque … here is an underemphasis of clinical features in the diagnosis of PG, which can potentially lead to overdiagnosis. Establishing firm clinical criteria for diagnosing PG will ensure that case reports describe the same disease. This has implications in optimizing treatment strategies and improving patient outcomes.

Clinical characteristics of depressed outpatients previously overdiagnosed with bipolar disorder.

The diagnosis of bipolar disorder in depressed patients requires the ascertainment of prior episodes of mania and hypomania. Several researc … d is whether there is a particular clinical or demographic profile associated with bipolar disorder overdiagnosis among depressed patients. Forty psychiatric outpatients with current major depressive disorder reported having been previously diagnosed with bipolar disorder, which was not confirmed when interviewed with the Structured Clinical Interview for Diagn …

Bone mineral density of the spine and femur in healthy Saudis.

The reference values of bone mineral density (BMD) were determined in healthy Saudis of both sexes and compared with US / northern European … erscores the importance of using population-specific reference values for BMD measurements to avoid overdiagnosis and/or underdiagnosis of osteoporosis.

Odontogenic cysts, odontogenic tumors, fibroosseous, and giant cell lesions of the jaws.

Odontogenic cysts that can be problematic because of recurrence and/or aggressive growth include odontogenic keratocyst (OKC), calcifying od … myxoma, odontogenic fibroma, desmoplastic fibroma) is necessary to avoid the diagnostic pitfall of overdiagnosis of similar-appearing follicular sacs and dental pulps. Fibroosseous lesions of the jaws show considerable microscopic overlap and include fibrous dysplasia, ossifying fibroma, periapical cementoosseous dysplasia, and low-grade chronic osteomyelitis. …