Abstract:
:The present paper analyses the epidemiologic effects of mass breast cancer screening. Mass mammography may possibly achieve a breast cancer mortality reduction in relative risk terms. However, this does not necessarily represent a net benefit. It is argued that the benefits and adverse effects of a screening programme must be measured in terms of absolute risks. According to this measure, the mortality reduction achieved by a mass breast screening programme is only one death per approx. 15,000 women-years. Many thousands of mammograms are needed to prevent one cancer death, and for each woman who can derive a direct benefit in terms of a prevented breast cancer death, hundreds of women have to suffer the anxiety of a positive screening mammography. Moreover, it is possible that adverse effects of breast cancer screening may contribute to mortality from other causes. Even with the assumption that screening can save lives, the net health effect of mass breast cancer screening is questionable and appears to be rather detrimental. It may be an error to recommend mass breast screening.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Schmidt JGdoi
10.1016/0895-4356(90)90002-7subject
Has Abstractpub_date
1990-01-01 00:00:00pages
215-25issue
3eissn
0895-4356issn
1878-5921pii
0895-4356(90)90002-7journal_volume
43pub_type
杂志文章,评审abstract::Nonresponse and methods of data collection could affect satisfaction measurement. The goal of this study was to estimate the impact of (1) nonresponse and (2) distribution method on evaluation of patient satisfaction in a mail-back study measuring patient opinion of medical and nursing care. The study was conducted in...
journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0895-4356(01)00387-0
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVES:To assess how trial information reported in conference abstracts differs to their subsequent full publication. METHODS:Randomized trials reported at the American Society of Clinical Oncology conference (1992) were identified. CENTRAL and PubMed (December 2002) were searched to identify corresponding full pu...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2005.09.016
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:In the development of search strategies for systematic reviews, "conceptual approaches" are generally recommended to identify appropriate search terms for those parts of the strategies for which no validated search filters exist. However, "objective approaches" based on search terms identified by text analys...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2016.05.002
更新日期:2016-09-01 00:00:00
abstract::The microbial flora on the surfaces of 15 books obtained from a public library and from 15 books obtained from a family household were studied. Staphylococcus epidermidis was recovered from 4 of the library books and 3 of the family household books. The number of organisms per page was between one to four. This data i...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(94)90103-1
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVES:Emergency department triage systems can be considered prediction rules with an ordinal outcome, where different directions of misclassification have different clinical consequences. We evaluated strategies to compare the performance of triage systems and aimed to propose a set of performance measures that sh...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2017.11.004
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:Graphical methods for generating explanatory hypotheses from limited categorical data are described and illustrated. STUDY DESIGN AND SETTING:Univariate, bivariate, multivariate, and multiplicative graphical methods were applied to clinical data regarding very ill older persons. The data to which these metho...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2011.06.007
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVES:To evaluate in how many cancer-related Cochrane reviews hazard ratio (HR)-based absolute effects in summary of findings (SoF) tables have been correctly calculated and reported. STUDY DESIGN AND SETTING:We identified all Cochrane cancer intervention reviews that reported an HR for at least one outcome and p...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2018.12.006
更新日期:2019-04-01 00:00:00
abstract::Criterion validity studies sometimes use designs with test-based enrollment schemes. In such incomplete studies, a Reference Instrument (RI) is applied to unequal sampling fractions of subjects previously identified as positives or negatives by a new Test Instrument (TI+ and TI-). Focusing on sensitivity (Se) and spec...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(03)00162-8
更新日期:2003-10-01 00:00:00
abstract::To compare Charlson indices based on chart data and ICD-9 data for agreement overall and on rating specific comorbid conditions, and to compare mortality risks associated with these indices. Prospective cohort study. Six general medicine wards at Yale-New Haven Hospital. 524 consecutive patients who had no clinical ev...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(00)00367-x
更新日期:2001-07-01 00:00:00
abstract::Recently, there has been a great deal of discussion regarding the use of administrative databases to study outcomes of medical care. A major issue in this discussion is how to classify patients in terms of characteristics such as disease-severity, comorbidities, resource needs, stability, etc. Different indices have b...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(94)00202-2
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVES:This study investigated trial consultations to identify whether and to what extent discussions of retention are present. STUDY DESIGN AND SETTING:This embedded mixed-methods study design included a purposive sample of audio-recorded trial consultations obtained from four sites of a large multicenter UK-base...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2020.03.011
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVES:To illustrate how multiple hypotheses testing can produce associations with no clinical plausibility. STUDY DESIGN AND SETTING:We conducted a study of all 10,674,945 residents of Ontario aged between 18 and 100 years in 2000. Residents were randomly assigned to equally sized derivation and validation cohort...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2006.01.012
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:To assess measurement equivalence of the Singaporean English and Chinese versions of the EuroQol Group's 5-domain questionnaire (EQ-5D) in cancer patients. STUDY DESIGN AND SETTING:Seven hundred and seventy-one ethnic Chinese patients in Singapore were recruited, and they answered either an English or a Chin...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2008.03.007
更新日期:2009-02-01 00:00:00
abstract::The objective of this study was to identify characteristics of nonrespondents and late respondents in a population-based case-control study on lung cancer conducted in the city of Turin (Italy). Information about demographic and socioeconomic variables of 634 cases and 859 controls who responded to an interview, as we...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(02)00455-9
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:To describe the pain decrease considered as clinically relevant when designing a trial and reporting its results. METHODS:A systematic review of the literature in MEDLINE was conducted to select randomized controlled trials (RCTs) with pain as a primary outcome. Data extracted included the definition (terms ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2010.06.008
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVES:We sought to identify the proportion of systematic reviews of adverse effects which search for unpublished data and the success rates of identifying unpublished data for inclusion in a systematic review. STUDY DESIGN AND SETTING:Two reviewers independently screened all records published in 2014 in the Datab...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2016.05.003
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVES:Timely and comprehensive reporting of clinical trial results builds the backbone of evidence-based medicine and responsible research. The proportion of timely disseminated trial results can inform alternative national and international benchmarking of university medical centers (UMCs). STUDY DESIGN AND SETT...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2019.06.002
更新日期:2019-11-01 00:00:00
abstract::Time to revision is an important criterion describing the quality of implants in total joint surgery. Estimates of failure probabilities are required to inform a patient about the risk of suffering a reoperation. Also, regression models are used for comparing different prosthesis designs. Typically, patients dying bef...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(01)00371-7
更新日期:2001-10-01 00:00:00
abstract::This article (Part II) and the preceding article (Part I) report the development of two clinical staging systems for HIV-infected individuals. The objective of the research reported here (Part II) was to construct a clinical staging system to predict survival in patients with AIDS. We analyzed data from VA Cooperative...
journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0895-4356(97)00182-0
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:Traditionally, measures have been developed using classical test theory (CTT). This study examines the psychometrics of the PedsQL 4.0 Generic Core Scales (parent report) using a modern psychometric approach (i.e., Rasch analysis) to determine if further insight regarding the behavior of the measure can be ga...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jclinepi.2012.04.014
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:N-of-1 trials can be aggregated to estimate population treatment effects using hierarchical Bayesian models. It is very important to report core items in hierarchical Bayesian analysis. In this study, we assessed reporting of items in hierarchical Bayesian analysis for aggregating N-of-1 trials to estimate p...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2016.02.023
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To examine the impact of changes in comorbidity--as measured by the Charlson comorbidity index--on self-rated health in a large sample of community-dwelling elderly over a 1-year period, and to examine the differential effects of changes in specific Charlson diagnostic categories. STUDY DESIGN AND SETTING:Lo...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2008.05.009
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:Loss to follow-up threatens internal and external validity yet little research has examined ways to limit participant attrition. We conducted a systematic review of studies with a primary focus on strategies to retain participants in health care research. STUDY DESIGN AND SETTINGS:We completed searches of Pu...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2006.11.023
更新日期:2007-08-01 00:00:00
abstract::During 1978-1990, 346 patients with sarcoidosis were enrolled in our institute. Of 346 patients, 295 patients were eligible for evaluation on the clinical course and prognosis. According of their clinical presentations, they were classified into 3 groups; severe, moderate and mild sarcoidosis. Of the 295 patients, 27 ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(93)90150-y
更新日期:1993-04-01 00:00:00
abstract::To effectively evaluate medical literature, practicing physicians and medical researchers must understand the impact of statistical tests on research outcomes. Applying inefficient statistics not only increases the need for resources, but more importantly increases the probability of committing a Type I or Type II err...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(98)00168-1
更新日期:1999-03-01 00:00:00
abstract::The purpose of this study was to assess the association between the international overweight cutoffs for children and youth and coronary heart disease risk factors. The sample included 410 boys and 337 girls 9-18 years of age from the Québec Family Study. Participants were classified as normal weight or overweight usi...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(02)00595-4
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:This study tested the impact of web administration on well-established measures of children's physical function and quality of life. STUDY DESIGN AND SETTING:Participants were recruited from clinics at six hospitals. They completed the Activities Scale for Kids (ASK) and the Pediatric Quality of Life Invento...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jclinepi.2008.06.011
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVES:To solicit experiences with and perceptions of rapid reviews from stakeholders, including researchers, policy makers, industry, journal editors, and health care providers. STUDY DESIGN AND SETTING:An international survey of rapid review producers and modified Delphi. RESULTS:Forty rapid review producers re...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2015.08.012
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:Lower levels of serum albumin are associated with increased risk of all-cause and cardiovascular mortality as well as with coronary heart disease and stroke incidence. These relationships have been examined with specific focus on the role of cigarette smoking. STUDY DESIGN AND SETTING:A prospective study of ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2003.07.001
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:Cochrane acute respiratory infections (ARIs) group conducts systematic reviews of the evidence for treatment and prevention of ARIs. We report the results of a prioritization project, aiming to identify highest priority systematic review topics. STUDY DESIGN/SETTING:The project consisted of two phases. Phase...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2018.05.016
更新日期:2018-10-01 00:00:00