Overdiagnosis, incidental findings and Socrates’ three sieves

Raymond, Jean; Long, Hélène; Roy, David J.

doi:10.1016/j.neurad.2016.12.010

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…The high capacity of detection of soft tissue calcifications by CBCT may lead to overdiagnosis of these conditions, as observed in this study. Thus, even when the imaging finding is not related to no clinical concern, it is included in the diagnostic evaluation and can deviates healthcare professionals from caring about other health issues (Chiolero et al., ; Raymond, Long, & Roy, ). In addition, overdiagnosis of conditions requiring treatment or follow‐up may also be of warning because the actual rate of clinical events that occur from incidentally diagnosed cases is still uncertain.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, overdiagnosis of conditions requiring treatment or follow‐up may also be of warning because the actual rate of clinical events that occur from incidentally diagnosed cases is still uncertain. On the other hand, it is not known if the cost‐benefit and risk‐benefit ratios of intervening on these patients are favorable as shown for more severe forms of the disease (when the imaging exams are indicated for specific evaluation of such conditions rather than being incidental findings) (Chiolero et al., ; Raymond et al., ). Currently, this issue has generated a discussion on the real importance of the radiologist recording all the incidental findings or even giving a consideration of their clinical relevance in the radiological report.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of soft tissue calcifications in the maxillofacial region detected by cone beam CT

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence of soft tissue calcifications in the maxillofacial region detected by cone beam CT

et al. 2018

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“…Incidental findings : Incidental findings are radiological abnormalities not caused by the symptoms being investigated that may drive further imaging and concern. 29 To understand incidental findings in patients referred to SCAN, demographic, clinical and radiological information will be extracted from the SCAN database. Imaging findings will be categorised per anatomical location.…”

Section: Discussionmentioning

confidence: 99%

The Suspected CANcer (SCAN) pathway: protocol for evaluating a new standard of care for patients with non-specific symptoms of cancer

et al. 2018

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IntroductionCancer survival in England lags behind most European countries, due partly to lower rates of early stage diagnosis. We report the protocol for the evaluation of a multidisciplinary diagnostic centre-based pathway for the investigation of ‘low-risk but not no-risk’ cancer symptoms called the Suspected CANcer (SCAN) pathway. SCAN is a new standard of care being implemented in Oxfordshire; one of a number of pathways implemented during the second wave of the Accelerate, Coordinate, Evaluate (ACE) programme, an initiative which aims to improve England’s cancer survival rates through establishing effective routes to early diagnosis.Methods and analysisTo evaluate SCAN, we are collating a prospective database of patients referred onto the pathway by their general practitioner (GP). Patients aged over 40 years, with non-specific symptoms such as weight loss or fatigue, who do not meet urgent cancer referral criteria or for whom symptom causation remains unclear after investigation via other existing pathways, can be referred to SCAN. SCAN provides rapid CT scanning, laboratory testing and clinic review within 2 weeks. We will follow all patients in the primary and secondary care record for at least 2 years. The data will be used to understand the diagnostic yield of the SCAN pathway in the short term (28 days) and the long term (2 years). Routinely collected primary and secondary care data from patients not referred to SCAN but with similar symptoms will also be used to evaluate SCAN. We will map the routes to diagnosis for patients referred to SCAN to assess cost-effectiveness. Acceptability will be evaluated using patient and GP surveys.Ethics and disseminationThe Oxford Joint Research Office Study Classification Group has judged this to be a service evaluation and so outside of research governance. The results of this project will be disseminated by peer-reviewed publication and presentation at conferences.

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“…There is no universal consensus on how to handle incidental imaging findings 81,82 which is not surprising given their scope, variety and complexity. 69,83 Radiologists have created different rating scales to denote their risk of malignancy, mostly for MR and CT imaging of specific tissues in certain clinical situations, but even in such narrow contexts broad consensus is difficult to achieve. Neuromuscular sonographers, because of their ability to further examine patients, have an advantage in managing unexpected findings over those who interpret radiologic images remotely.…”

Section: Reporting Uncommon Incidental or Atypical Findingsmentioning

confidence: 99%

Managing uncommon and unexpected findings during neuromuscular ultrasound

2020

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One barrier to widespread adoption of neuromuscular ultrasound by clinical neurophysiologists is concern over how to identify and manage non-neuromuscular findings. This review addresses this concern by describing the sonographic appearance of a variety of commonly observed pathologies and anatomic variants in dermal, subcutaneous, bony, glandular, lymphatic, vascular, and other superficial tissues. Additionally, it outlines techniques to ensure proper clinical and ultrasound evaluation of unexpected or uncommon findings. Finally, it highlights strategies to manage unexpected findings, including how to best communicate findings to patients and referring clinicians to avoid unnecessary testing and ensure appropriate follow-up. Ultrasound extends the ability of the neuromuscular sonographer-clinician to contribute to patient care.

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Overdiagnosis, incidental findings and Socrates’ three sieves

Cited by 4 publications

References 8 publications

Prevalence of soft tissue calcifications in the maxillofacial region detected by cone beam CT

Prevalence of soft tissue calcifications in the maxillofacial region detected by cone beam CT

The Suspected CANcer (SCAN) pathway: protocol for evaluating a new standard of care for patients with non-specific symptoms of cancer

Managing uncommon and unexpected findings during neuromuscular ultrasound

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