The Harms of Overdiagnosis and Overtreatment in Patients with Small Renal Masses: A Mini-review

Sohlberg, Ericka; Metzner, Thomas J.; Leppert, John T.

doi:10.1016/j.euf.2019.03.006

Cited by 47 publications

(27 citation statements)

References 13 publications

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“…Diagnoses of RCC often occur in the sixth decade of life, during exams (i.e., abdomen imaging) performed for other reasons or within screening programs, and at an early stage (< 4 cm of diameter). Such small renal masses are often indolent, and in the last few years, awareness about the potential harm derived from overdiagnosis and overtreatment of patients diagnosed with kidney cancer is rising [3].…”

Section: Introductionmentioning

confidence: 99%

Biomarkers for Renal Cell Carcinoma Recurrence: State of the Art

et al. 2021

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Purpose of Review We aim to summarize the current state of art about the possible use of biomarkers for predicting renal cell carcinoma (RCC) recurrence after curative treatment. In addition, we aim to provide a snapshot about the clinical implication of biomarkers use for follow-up planification. Recent Findings A wide variety of biomarkers have been proposed. RCC biomarkers have been individuated in tumoral tissue, blood, and urine. A variety of molecules, including proteins, DNA, and RNA, warrant a good accuracy for RCC recurrence and progression prediction. Their use in prediction models might warrant a better patients’ risk stratification. Summary Future prognostic models will probably include a combination of classical features (tumor grade, stage, etc.) and novel biomarkers. Such models might allow a more accurate treatment and follow-up planification.

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Section: Introductionmentioning

confidence: 99%

Biomarkers for Renal Cell Carcinoma Recurrence: State of the Art

et al. 2021

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“…However, laboratory testing is (inevitably) also associated with patient discomfort, and a plethora of test results may divert the physician's attention away from the clinically relevant information [9]. In addition, it may lead to overdiagnosis, which may result in unnecessary, potentially harmful or costly downstream activities [10][11][12][13][14]. Indeed, previous studies suggest that, depending on the definition used, 30-70% of all laboratory tests may be considered potentially inappropriate [6,15,16].…”

Section: Introductionmentioning

confidence: 99%

Preventing overuse of laboratory diagnostics: a case study into diagnosing anaemia in Dutch general practice

Kip

Oonk

Levin

et al. 2020

BMC Med Inform Decis Mak

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Background: More information is often thought to improve medical decision-making, which may lead to test overuse. This study assesses which out of 15 laboratory tests contribute to diagnosing the underlying cause of anaemia by general practitioners (GPs) and determines a potentially more efficient subset of tests for setting the correct diagnosis. Methods: Logistic regression was performed to determine the impact of individual tests on the (correct) diagnosis. The statistically optimal test subset for diagnosing a (correct) underlying cause of anaemia by GPs was determined using data from a previous survey including cases of real-world anaemia patients. Results: Only 9 (60%) of the laboratory tests, and patient age, contributed significantly to the GPs' ability to diagnose an underlying cause of anaemia (CRP, ESR, ferritin, folic acid, haemoglobin, leukocytes, eGFR/MDRD, reticulocytes and serum iron). Diagnosing the correct underlying cause may require just five (33%) tests (CRP, ferritin, folic acid, MCV and transferrin), and patient age. Conclusions: In diagnosing the underlying cause of anaemia a subset of five tests has most added value. The realworld impact of using only this subset should be further investigated. As illustrated in this case study, a statistical approach to assessing the added value of tests may reduce test overuse.

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“…Thus, optimal calibration of both renal mass diagnosis and treatment is mandatory. Sohlberg et al [1] address the harms of both overdiagnosis and overtreatment in patients with a renal mass and provide guidance on how to best "stay on track" (Fig. 2 [1]).…”

mentioning

confidence: 99%

Modern Management of Kidney Cancer: Is a Chance to Cut a Chance to Cure?

Kutikov

2019

European Urology Focus

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The Harms of Overdiagnosis and Overtreatment in Patients with Small Renal Masses: A Mini-review

Cited by 47 publications

References 13 publications

Biomarkers for Renal Cell Carcinoma Recurrence: State of the Art

Biomarkers for Renal Cell Carcinoma Recurrence: State of the Art

Preventing overuse of laboratory diagnostics: a case study into diagnosing anaemia in Dutch general practice

Modern Management of Kidney Cancer: Is a Chance to Cut a Chance to Cure?

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