By L. Santiago Medina
Evidence-Based Imaging offers the radiologist with a straight forward consultant to the evidence-based technological know-how and the benefit at the back of the diagnostic imaging stories played in drugs. This e-book offers the reader a clinically suitable assessment of epidemiology, collection of matters for imaging, choice of imaging recommendations, imaging attempt functionality and value, cost-effectiveness research, and applicability to childrens. 9 significant parts of clinical imaging are coated, with an emphasis on universal ailments. those contain Oncology, Neuroimaging, Gastroenterology, Pediatrics, breathing procedure, Musculoskeletal, Cardiovascular, Trauma, and Urologic. Radiologists, clinicians, citizens, and others with an curiosity in clinical imaging and a wish to continue present with the immense quantity of evidence-based literature will locate this article tremendous precious.
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Additional resources for Evidence-Based Imaging: Optimizing Imaging in Patient Care
Example text
Hosek R, Flanders W, Sasco A. Am J Epidemiol 1996;143:193–201. 22. Patz E, Goodman P, Bepler G. N Engl J Med 2000;343:1627–1633. 23. Black WC, Welch HG. AJR 1997;168:3–11. 24. Black W, Haggstrom D, Welch H. J Natl Cancer Inst 2002;94. 25. Kent DL, Haynor DR, Longstreth WT, Jr, Larson EB. Ann Intern Med 1994;120: 856–871. 27 3 Breast Imaging Laurie L. Fajardo, Wendie A. Berg, and Robert A. Smith Issues Mammography Screening I. II. III. IV. How effective is mammographic screening? Who should undergo screening?
Imaging Effectiveness Hierarchy Technical efficacy: production of an image or information Measures: signal-to-noise ratio, resolution, absence of artifacts Accuracy efficacy: ability of test to differentiate between disease and nondisease Measures: sensitivity, specificity, receiver operator characteristic curves Diagnostic-thinking efficacy: impact of test on likelihood of diagnosis in a patient Measures: pre- and posttest probability, diagnostic certainty Treatment efficacy: potential of test to change therapy for a patient Measures: treatment plan, operative or medical treatment frequency Outcome efficacy: effect of use of test on patient health Measures: mortality, quality adjusted life years, health status Societal efficacy: appropriateness of test from perspective of society Measures: cost-effectiveness analysis, cost-utility analysis Source: Adapted from Fryback and Thornbury (38).
Further, the benefit that was evident appeared much later in younger women, leading some to argue that the appearance of benefit was attributable to cases diagnosed after age 50 in the women who were randomized in their 40s (67). This argument persisted despite contrary evidence (40), and the eventual observation of statistically significant mortality reductions for this age group in two individual trials (Malmo II and Gothenburg) (44,47) and favorable meta-analysis results (32). Further, Tabar and colleagues (68,69) showed that the 24- to 33-month interval between screening exams in the Two County Study had been sufficient to reduce the incidence rate of advanced ductal grade 3 cancers in women aged 50+, but not in women aged 40 to 49.