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Новости за 11.06.2024

Late-Stage Cancer End Points to Speed Cancer Screening Clinical Trials—Not So Fast

Jamanetwork.com 

In this issue of JAMA, Feng et al studied whether late-stage cancer (ie, stage III or stage IV cancer), rather than cancer-specific mortality, was an acceptable alternative end point in clinical trials of cancer screening. The authors analyzed 41 clinical trials conducted in Europe, North America, and Asia, combining the data overall and according to cancer type. They evaluated the association between incidence of stage III-IV cancer and cancer-specific mortality in and across the selected studies.

USPSTF Recommendation: Screening for Breast Cancer

Jamanetwork.com 

This 2024 Recommendation Statement from the US Preventive Services Task Force recommends biennial screening mammography for women aged 40 to 74 years (B recommendation) and concludes that evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75 years or older (I statement) and of screening using ultrasonography or MRI in women with dense breasts on a negative mammogram (I statement).

USPSTF Review: Screening for Breast Cancer

Jamanetwork.com 

This systematic review to support a 2024 US Preventive Services Task Force Recommendation Statement summarizes published evidence on the benefits and harms of screening for breast cancer in adult females.

USPSTF Report: Collaborative Modeling to Compare Breast Cancer Screening Strategies

Jamanetwork.com 

This modeling study uses Cancer Intervention and Surveillance Modeling Network models and national data on breast cancer incidence, mammography performance, treatment effects, and other-cause mortality in US women without previous cancer diagnoses to estimate outcomes of various mammography screening strategies.

Screening for Breast Cancer

Jamanetwork.com 

In this JAMA Patient Page, the US Preventive Services Task Force provides a guide to screening for breast cancer.

Toward More Equitable Breast Cancer Outcomes

Jamanetwork.com 

In its revised Recommendation Statement, the US Preventive Services Task Force (USPSTF) now recommends that all women undergo routine breast cancer screening every other year beginning at age 40 years. This is an adjustment from the 2016 recommendation for all women to start at age 50 and for women aged 40 to 49 to engage in individualized decision-making and part of an overarching aim to increase earlier detection of breast cancer and address inequalities in breast cancer mortality, especially among Black women. Читать дальше...

Prognostic Value of Cardiovascular Biomarkers in the Population

Jamanetwork.com 

This study evaluates the prognostic value of routinely available cardiovascular biomarkers when added to established risk factors in the identification of individuals at high risk for atherosclerotic cardiovascular disease.

Apixaban to Prevent Recurrence After Cryptogenic Stroke—Reply

Jamanetwork.com 

In Reply In response to our recent article, Dr Chi and colleagues raise an important point regarding uncertainty about optimal biomarkers of atrial cardiopathy. Compared with ARCADIA patients who qualified for enrollment in our study only by the NT-proBNP criterion, those who qualified by only the electrocardiographic criterion had significantly younger mean age (64.1 vs 71.1 years), higher mean weight (87.0 vs 83.9 kg), and a lower mean CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years [doubled]... Читать дальше...

Apixaban to Prevent Recurrence After Cryptogenic Stroke

Jamanetwork.com 

To the Editor A recent clinical trial demonstrated that apixaban did not significantly reduce recurrent stroke risk compared with aspirin in patients with cryptogenic stroke and evidence of atrial cardiopathy without atrial fibrillation. However, we had some concerns about this study. First, it is likely that a substantial number of patients with patent foramen ovale (PFO) were enrolled in this study, but no data about them were presented. Both in vivo and in vitro studies have shown that left atrial... Читать дальше...

Can Cardiovascular Risk Assessment Be Improved in the 21st Century?

Jamanetwork.com 

Cardiovascular risk assessment has become an essential part of preventive strategies designed to target risk factor interventions and has contributed to dramatic reductions in cardiovascular disease mortality during the past 60 years in the US and other countries. Beginning in the 1960s, investigators from the Framingham Heart study identified key physiological, behavioral, and biochemical risk factors for atherosclerotic cardiovascular disease and were the first to develop multivariable risk equations... Читать дальше...

Fosamax Fractures

Jamanetwork.com 

This Viewpoint discusses the ongoing lawsuit between plaintiffs who had been affected by atypical femoral fractures while receiving alendronate and the drug manufacturer.

Poetry and the Meaning of Care

Jamanetwork.com 

Health care is becoming more and more distanced. Clinicians must overcome not just mountains of data, burdensome electronic health records, and ever-increasing numbers of machines that separate us from patients, but more recently also navigate telemedicine and AI-driven chatbots. Physician-writer Dr Abraham Verghese and others have lamented that consequently we rely less on the physical exam and the connection it fosters with patients, as echocardiography and CT scans impersonally scrutinize them instead. Читать дальше...

Even Joy

Jamanetwork.com 

Since her birth with half a brain The doctors have been kind, So awed by her determination they loan a private Room for the transient child to be and Show the worth of being Even if

I Kept Crying

Jamanetwork.com 

In this narrative medicine essay, a second-year pediatric resident bears the scars from the terror that descended the moment of her son’s birth at 31 weeks’ gestation, terror relived even after he has come home healthy.

AI-Generated Clinical Summaries—Reply

Jamanetwork.com 

In Reply We thank Ms Chen and Dr Thornton for their interest in our Viewpoint examining potential benefits and challenges of AI-generated clinical summaries. We fully agree that future studies should evaluate how AI summaries influence physician decision-making and clinical outcomes. We disagree, however, that calling for the development of voluntary standards for evaluating AI-generated summaries and urging the FDA to clarify its oversight of the most clinically complex AI-summarization tools holds... Читать дальше...

AI-Generated Clinical Summaries

Jamanetwork.com 

To the Editor In their recent Viewpoint, Dr Goodman and colleagues examined artificial intelligence (AI)–generated clinical summaries and identified concerns regarding variability, bias, and single-word errors in their AI summaries generated through the ChatGPT model. However, it must be noted that human writers exhibit these same shortcomings in clinical summarization. While striving for an “ideal” clinical summary that avoids variability, bias, and error is a worthwhile goal, requiring such idealized... Читать дальше...