A need for improved understanding about USPSTF and other evidence-based recommendations

Saraiya, Mona; Benard, Vicki B.; White, Mary C.

doi:10.1016/j.ypmed.2013.12.028

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…Notably, small fibroids were excluded in most of the included studies, and in the case of patients with multiple myomas, only the largest was investigated through MRI. 41,42,44,54,55 This screening-like selection may reflect the daily practice that is applied during the differential diagnosis. This process may have even underestimated the specificity and diagnostic accuracy of MRI.…”

Section: Discussionmentioning

confidence: 99%

“…According to our results, MRI showed a very high accuracy, with an excellent pooled specificity, identifying it as a reliable tool in the detection of benign lesions. Notably, small fibroids were excluded in most of the included studies, and in the case of patients with multiple myomas, only the largest was investigated through MRI 41,42,44,54,55 . This screening‐like selection may reflect the daily practice that is applied during the differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic accuracy of MRI in the differential diagnosis between uterine leiomyomas and sarcomas: A systematic review and meta‐analysis

Raffone,

Raimondo,

Neola

et al. 2023

Intl J Gynecology & Obste

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BackgroundDifferential diagnosis between uterine leiomyomas and sarcomas is challenging. Magnetic resonance imaging (MRI) represents the second‐line diagnostic method after ultrasound for the assessment of uterine masses.ObjectivesTo assess the accuracy of MRI in the differential diagnosis between uterine leiomyomas and sarcomas.Search StrategyA systematic review and meta‐analysis was performed searching five electronic databases from their inception to June 2023.Selection CriteriaAll peer‐reviewed observational or randomized clinical trials that reported an unbiased postoperative histologic diagnosis of uterine leiomyoma or uterine sarcoma, which also comprehended a preoperative MRI evaluation of the uterine mass.Data Collection and AnalysisSensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, and area under the curve on summary receiver operating characteristic of MRI in differentiating uterine leiomyomas and sarcomas were calculated as individual and pooled estimates, with 95% confidence intervals (CI).ResultsEight studies with 2495 women (2253 with uterine leiomyomas and 179 with uterine sarcomas), were included. MRI showed pooled sensitivity of 0.90 (95% CI 0.84–0.94), specificity of 0.96 (95% CI 0.96–0.97), positive likelihood ratio of 13.55 (95% CI 6.20–29.61), negative likelihood ratio of 0.08 (95% CI 0.02–0.32), diagnostic odds ratio of 175.13 (95% CI 46.53–659.09), and area under the curve of 0.9759.ConclusionsMRI has a high diagnostic accuracy in the differential diagnosis between uterine leiomyomas and sarcomas.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of MRI in the differential diagnosis between uterine leiomyomas and sarcomas: A systematic review and meta‐analysis

Raffone,

Raimondo,

Neola

et al. 2023

Intl J Gynecology & Obste

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“…Numerous studies to date have examined why guidelines are not being practiced. [ 5 6 7 8 9 10 11 12 13 ] Over 290 barriers to preventive medicine discussions with patients have been explored, including lack of time, patient refusal or hesitance, inadequate insurance reimbursement, and lack of physician knowledge. [ 5 6 ] A study assessing the average amount of time needed daily to discuss all preventive medicine topics per USPSTF recommendations found that 7.4 h per working day would be required.…”

Section: Introductionmentioning

confidence: 99%

“…[ 5 ] Another important barrier to acknowledge is physician disagreement with the guidelines. [ 7 8 9 10 ] Guideline complexity and perceived lack of evidence are other commonly cited barriers. [ 7 11 12 13 ]…”

Section: Introductionmentioning

confidence: 99%

Primary care physicians practicing preventive medicine in the outpatient setting

et al. 2016

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Background:Preventive care is an important part of primary care medicine, yet much variation in its practice exists. The aim of this study is to assess physicians’ perspectives of practicing preventive medicine and evaluate which topics are deemed most important.Methods:All primary care medicine providers at two separate academic medical centers (Mayo Clinic, MN and Mayo Clinic, FL) were surveyed via an E-mail questionnaire assessing physicians’ perception of the role of preventive medicine during both acute/routine and yearly visits, physicians’ perception of patients’ response to preventive medicine topics, and which preventive medicine topics are commonly practiced.Results:Of 445 providers meeting inclusion criteria, a total of 183 (41.1%) responded. Providers were more likely to engage patients in preventive medicine during yearly visits more so than acute visits (3.82 vs. 4.72, range 1–5 Likert Scale), yet providers were very likely to partake in such practices during both visits. Providers perceived that patients received the practice of preventive medicine very well (4.13 on 1–5 Likert Scale). No significant difference between provider practice and patient perception was noted between the two sites, although there was some variation based on clinical experience of the provider. Providers were found to most commonly practice topics recommended by the United States Preventive Services Task Force.Conclusions:Our study found a high predisposition to practicing preventive medicine. Providers seem to practice according to published evidence-based medicine recommendations.

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Considerations for using potential surrogate endpoints in cancer screening trials

Webb,

Berg,

Castle

et al. 2024

The Lancet Oncology

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A need for improved understanding about USPSTF and other evidence-based recommendations

Cited by 3 publications

References 18 publications

Diagnostic accuracy of MRI in the differential diagnosis between uterine leiomyomas and sarcomas: A systematic review and meta‐analysis

Diagnostic accuracy of MRI in the differential diagnosis between uterine leiomyomas and sarcomas: A systematic review and meta‐analysis

Primary care physicians practicing preventive medicine in the outpatient setting

Considerations for using potential surrogate endpoints in cancer screening trials

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