Increase in incidence of disease due to diagnostic drift: primary liver cancer in Denmark, 1943-85.

Abstract:

OBJECTIVE:To examine the extent to which changes in diagnostic methods and classification are responsible for the striking increase in incidence of primary liver cancer in Denmark since 1943. DESIGN:Analysis of the time trends in sex specific, age standardised incidence of primary liver cancer and unspecified liver cancer (either secondary without known primary cancer or not specified as primary cancer) in the entire population from 1943 to 1985. By review of the 727 notifications from three periods of 5 years (1948-52, 1963-7, and 1978-82) the changes in histological diagnosis and classification were assessed. SETTING:Denmark. SUBJECTS:Notifications of liver cancer to the Danish cancer registry. RESULTS:Concomitant with the increase in primary liver cancer, the incidence of the unspecified liver cancer declined. The proportion of histologically diagnosed primary liver cancer rose from 85% to 98%, whereas the proportion for unspecified liver cancer rose from 12% to 51%. When the proportion of primary versus unspecified liver cancer obtained by histological diagnosis was extrapolated to all cases, the annual incidence of primary liver cancer was 4.4 rather than 1.6 per 100,000 population in 1948-52 and 6.0 rather than 5.5 per 100,000 in 1978-82. CONCLUSION:The increase in the incidence of primary liver cancer may be much smaller than the numbers of registered cases indicate. This example emphasises the need to consider diagnostic drift in time trend studies of disease incidence.

journal_name

BMJ

authors

Anderson IB,Sørensen TI,Prener A

doi

10.1136/bmj.302.6774.437

subject

Has Abstract

pub_date

1991-02-23 00:00:00

pages

437-40

issue

6774

eissn

0959-8138

issn

1756-1833

journal_volume

302

pub_type

杂志文章
  • Evaluation of aid to diagnosis of pigmented skin lesions in general practice: controlled trial randomised by practice.

    abstract:OBJECTIVES:To determine whether an aid to the diagnosis of pigmented skin lesions reduces the ratio of benign lesions to melanomas excised in general practice. DESIGN:Controlled trial randomised by practice. SETTING:General practices in Perth, Western Australia. PARTICIPANTS:468 general practitioners in 223 practice...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.327.7411.375

    authors: English DR,Burton RC,del Mar CB,Donovan RJ,Ireland PD,Emery G

    更新日期:2003-08-16 00:00:00

  • Bicycle weight and commuting time: randomised trial.

    abstract:OBJECTIVE:To determine whether the author's 20.9 lb (9.5 kg) carbon frame bicycle reduced commuting time compared with his 29.75 lb (13.5 kg) steel frame bicycle. DESIGN:Randomised trial. SETTING:Sheffield and Chesterfield, United Kingdom, between mid-January 2010 and mid-July 2010. PARTICIPANTS:One consultant in an...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmj.c6801

    authors: Groves J

    更新日期:2010-12-09 00:00:00

  • Tocolytic therapy for preterm delivery: systematic review and network meta-analysis.

    abstract:OBJECTIVE:To determine the most effective tocolytic agent at delaying delivery. DESIGN:Systematic review and network meta-analysis. DATA SOURCES:Cochrane Central Register of Controlled Trials, Medline, Medline In-Process, Embase, and CINAHL up to 17 February 2012. STUDY SELECTION:Randomised controlled trials of toco...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.e6226

    authors: Haas DM,Caldwell DM,Kirkpatrick P,McIntosh JJ,Welton NJ

    更新日期:2012-10-09 00:00:00

  • Interventions used in disease management programmes for patients with chronic illness-which ones work? Meta-analysis of published reports.

    abstract:OBJECTIVE:To systematically evaluate the published evidence regarding the characteristics and effectiveness of disease management programmes. DESIGN:Meta-analysis. DATA SOURCES:Computerised databases for English language articles during 1987-2001. STUDY SELECTION:102 articles evaluating 118 disease management progra...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.325.7370.925

    authors: Weingarten SR,Henning JM,Badamgarav E,Knight K,Hasselblad V,Gano A Jr,Ofman JJ

    更新日期:2002-10-26 00:00:00

  • Inverse association between cancer and Alzheimer's disease: results from the Framingham Heart Study.

    abstract:OBJECTIVES:To relate cancer since entry into the Framingham Heart Study with the risk of incident Alzheimer's disease and to estimate the risk of incident cancer among participants with and without Alzheimer's disease. DESIGN:Community based prospective cohort study; nested age and sex matched case-control study. SET...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e1442

    authors: Driver JA,Beiser A,Au R,Kreger BE,Splansky GL,Kurth T,Kiel DP,Lu KP,Seshadri S,Wolf PA

    更新日期:2012-03-12 00:00:00

  • Management of chronic hepatitis B infection.

    abstract::Hepatitis B virus (HBV) is a global health problem that can lead to cirrhosis and hepatocellular carcinoma (HCC). Although HBV vaccination has reduced the prevalence Of HBV infection, the burden of disease remains high. Treatment with antiviral drugs reduces the risk of liver disease and the development of HCC, and it...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.h4263

    authors: Sundaram V,Kowdley K

    更新日期:2015-10-21 00:00:00

  • Damage to DNA in cervical epithelium related to smoking tobacco.

    abstract:OBJECTIVE:To determine whether tobacco smoking causes increased DNA modification (adducts) in human cervical epithelium. DESIGN:Comparison of DNA adducts measured by the technique of postlabelling with phosphorus-32 in normal ectocervical epithelium of smokers and non-smokers. A questionnaire on smoking habit and a ur...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.306.6890.1444

    authors: Simons AM,Phillips DH,Coleman DV

    更新日期:1993-05-29 00:00:00

  • Cohort study of hepatotoxicity associated with nimesulide and other non-steroidal anti-inflammatory drugs.

    abstract:OBJECTIVE:To estimate the risk of acute hepatotoxicity associated with nimesulide compared with other non-steroidal anti-inflammatory drugs. DESIGN:Retrospective cohort and nested case-control study. SETTING:Umbria region, Italy. PARTICIPANTS:400 000 current, recent, and past users (almost 2 million prescriptions) o...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.327.7405.18

    authors: Traversa G,Bianchi C,Da Cas R,Abraha I,Menniti-Ippolito F,Venegoni M

    更新日期:2003-07-05 00:00:00

  • Tired, weak, or in need of rest: fatigue among general practice attenders.

    abstract:OBJECTIVES:To determine the prevalence and associations of symptoms of fatigue. DESIGN:Questionnaire survey. SETTING:London general practice. PARTICIPANTS:611 General practice attenders. MAIN OUTCOME MEASURES:Scores on a fatigue questionnaire and reasons given for fatigue. RESULTS:10.2% Of men (17/167) and 10.6% o...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.301.6762.1199

    authors: David A,Pelosi A,McDonald E,Stephens D,Ledger D,Rathbone R,Mann A

    更新日期:1990-11-24 00:00:00

  • Progression of HIV disease in a haemophilic cohort followed for 11 years and the effect of treatment.

    abstract:OBJECTIVE:To describe the progression of HIV disease in a haemophilic cohort and to show the influence of treatment. DESIGN:11 year longitudinal clinical and laboratory study. SETTING:A haemophilia centre. PATIENTS:111 patients infected with HIV during October 1979 to July 1985. MAIN OUTCOME MEASURES:Symptoms of HI...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章

    doi:10.1136/bmj.303.6810.1093

    authors: Lee CA,Phillips AN,Elford J,Janossy G,Griffiths P,Kernoff P

    更新日期:1991-11-02 00:00:00

  • Vocational training for general practice in inner London. Is there a dearth? And if so what's to be done?

    abstract:OBJECTIVE:To identify the nature and extent of any vocational training deficit within the London initiative zone and investigate the reasons. DESIGN:Collation of statistics and postal questionnaire surveys. SETTING:Thames regions inside and outside the London initiative zone. SUBJECTS:General practice registrars, tr...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.312.7023.97

    authors: Harris T,Silver T,Rink E,Hilton S

    更新日期:1996-01-13 00:00:00

  • Readmission after hysterectomy and prophylactic low molecular weight heparin: retrospective case-control study.

    abstract:OBJECTIVE:To determine whether use of tinzaparin, a low molecular weight heparin introduced for prophylactic management of deep vein thrombosis, increases the risk of serious postoperative bleeding leading to a higher than expected 28 day readmission rate after discharge for hysterectomy. DESIGN:Retrospective case-con...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.38783.624444.55

    authors: Cook G,Depares J,Singh M,McElduff P

    更新日期:2006-04-08 00:00:00

  • Smoking cessation and reduction in people with chronic mental illness.

    abstract::The high prevalence of cigarette smoking and tobacco related morbidity and mortality in people with chronic mental illness is well documented. This review summarizes results from studies of smoking cessation treatments in people with schizophrenia, depression, anxiety disorders, and post-traumatic stress disorder. It ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.h4065

    authors: Tidey JW,Miller ME

    更新日期:2015-09-21 00:00:00

  • Association of echocardiography before major elective non-cardiac surgery with postoperative survival and length of hospital stay: population based cohort study.

    abstract:OBJECTIVE:To determine the association of resting echocardiography before elective intermediate to high risk non-cardiac surgery with survival and length of hospital stay. DESIGN:Population based retrospective cohort study. SETTING:Acute care hospitals in Ontario, Canada, between 1 April 1999 and 31 March 2008. PART...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.d3695

    authors: Wijeysundera DN,Beattie WS,Karkouti K,Neuman MD,Austin PC,Laupacis A

    更新日期:2011-06-30 00:00:00

  • Re-evaluation of link between interpregnancy interval and adverse birth outcomes: retrospective cohort study matching two intervals per mother.

    abstract:OBJECTIVE:To re-evaluate the causal effect of interpregnancy interval on adverse birth outcomes, on the basis that previous studies relying on between mother comparisons may have inadequately adjusted for confounding by maternal risk factors. DESIGN:Retrospective cohort study using conditional logistic regression (mat...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.g4333

    authors: Ball SJ,Pereira G,Jacoby P,de Klerk N,Stanley FJ

    更新日期:2014-07-23 00:00:00

  • Particulate air pollution and mortality in 38 of China's largest cities: time series analysis.

    abstract::Objectives To estimate the short term effect of particulate air pollution (particle diameter <10 μm, or PM10) on mortality and explore the heterogeneity of particulate air pollution effects in major cities in China.Design Generalised linear models with different lag structures using time series data.Setting 38 of the ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.j667

    authors: Yin P,He G,Fan M,Chiu KY,Fan M,Liu C,Xue A,Liu T,Pan Y,Mu Q,Zhou M

    更新日期:2017-03-14 00:00:00

  • Risks of adverse pregnancy and birth outcomes in women treated or not treated with mood stabilisers for bipolar disorder: population based cohort study.

    abstract:OBJECTIVE:To investigate the risks of adverse pregnancy and birth outcomes for treated and untreated bipolar disorder during pregnancy. DESIGN:Population based cohort study using data from national health registers. SETTING:Sweden. PARTICIPANTS:332,137 women with a last menstrual period anytime after 1 July 2005 and...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e7085

    authors: Bodén R,Lundgren M,Brandt L,Reutfors J,Andersen M,Kieler H

    更新日期:2012-11-08 00:00:00

  • Effects of alternative maternal micronutrient supplements on low birth weight in rural Nepal: double blind randomised community trial.

    abstract:OBJECTIVE:To assess the impact on birth size and risk of low birth weight of alternative combinations of micronutrients given to pregnant women. DESIGN:Double blind cluster randomised controlled trial. SETTING:Rural community in south eastern Nepal. PARTICIPANTS:4926 pregnant women and 4130 live born infants. INTER...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.326.7389.571

    authors: Christian P,Khatry SK,Katz J,Pradhan EK,LeClerq SC,Shrestha SR,Adhikari RK,Sommer A,West KP Jr

    更新日期:2003-03-15 00:00:00

  • Diabetes registers: a grassroots approach.

    abstract:OBJECTIVES:To compile a register of diabetic patients within the catchment area of a district general hospital and evaluate the characteristics of the population using aggregated data from a general practice audit. DESIGN:Cross sectional study. Practices identified all known diabetics and completed a questionnaire fro...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.307.6911.1046

    authors: Howitt AJ,Cheales NA

    更新日期:1993-10-23 00:00:00

  • Ethnic differences in risk of compulsory psychiatric admission among representative cases of psychosis in London.

    abstract:OBJECTIVE:To compare the risk of detention under the Mental Health Act 1983 in a representative group of people with psychotic disorders from different ethnic groups. SETTING:Two defined geographical areas in south London. DESIGN:Annual period prevalent cases of psychosis were identified in 1993 in the study areas fr...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.312.7030.533

    authors: Davies S,Thornicroft G,Leese M,Higgingbotham A,Phelan M

    更新日期:1996-03-02 00:00:00

  • Cardiovascular mortality in Dutch men during 1996 European football championship: longitudinal population study.

    abstract:OBJECTIVE:To investigate whether an important football match increases stress to such an extent that it triggers acute myocardial infarction and stroke. DESIGN:Longitudinal study of mortality around 22 June 1996 (the day the Dutch football team was eliminated from the European football championship). Mortality on 22 J...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.321.7276.1552

    authors: Witte DR,Bots ML,Hoes AW,Grobbee DE

    更新日期:2000-12-23 00:00:00

  • Real world effectiveness of warfarin among ischemic stroke patients with atrial fibrillation: observational analysis from Patient-Centered Research into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) study.

    abstract:OBJECTIVE:To examine the association between warfarin treatment and longitudinal outcomes after ischemic stroke in patients with atrial fibrillation in community practice. DESIGN:Observational study. SETTING:Hospitals (n = 1487) participating in the Get With The Guidelines (GWTG)-Stroke program in the United States, ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.h3786

    authors: Xian Y,Wu J,O'Brien EC,Fonarow GC,Olson DM,Schwamm LH,Bhatt DL,Smith EE,Suter RE,Hannah D,Lindholm B,Maisch L,Greiner MA,Lytle BL,Pencina MJ,Peterson ED,Hernandez AF

    更新日期:2015-07-31 00:00:00

  • Prevalence of microcephaly in Europe: population based study.

    abstract:OBJECTIVES: To provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe, and evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Conge...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.i4721

    authors: Morris JK,Rankin J,Garne E,Loane M,Greenlees R,Addor MC,Arriola L,Barisic I,Bergman JE,Csaky-Szunyogh M,Dias C,Draper ES,Gatt M,Khoshnood B,Klungsoyr K,Kurinczuk JJ,Lynch C,McDonnell R,Nelen V,Neville AJ,O'Mahony

    更新日期:2016-09-13 00:00:00

  • Accuracy of the "traffic light" clinical decision rule for serious bacterial infections in young children with fever: a retrospective cohort study.

    abstract:OBJECTIVES:To determine the accuracy of a clinical decision rule (the traffic light system developed by the National Institute for Health and Clinical Excellence (NICE)) for detecting three common serious bacterial infections (urinary tract infection, pneumonia, and bacteraemia) in young febrile children. DESIGN:Retro...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.f866

    authors: De S,Williams GJ,Hayen A,Macaskill P,McCaskill M,Isaacs D,Craig JC

    更新日期:2013-02-13 00:00:00

  • Cost effectiveness of treating primary care patients in accident and emergency: a comparison between general practitioners, senior house officers, and registrars.

    abstract:OBJECTIVES:To compare outcome and costs of general practitioners, senior house officers, and registrars treating patients who attended accident and emergency department with problems assessed at triage as being of primary care type. DESIGN:Prospective intervention study which was later costed. SETTING:Inner city acci...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.312.7042.1340

    authors: Dale J,Lang H,Roberts JA,Green J,Glucksman E

    更新日期:1996-05-25 00:00:00

  • Varenicline and risk of psychiatric conditions, suicidal behaviour, criminal offending, and transport accidents and offences: population based cohort study.

    abstract:OBJECTIVE:To examine associations between varenicline and the incidence of a range of adverse outcomes. DESIGN:Population based cohort study using within person analyses to control for confounding by indication. SETTING:Whole population of Sweden. PARTICIPANTS:7,917,436 people aged 15 and over, of whom 69,757 were t...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.h2388

    authors: Molero Y,Lichtenstein P,Zetterqvist J,Gumpert CH,Fazel S

    更新日期:2015-06-02 00:00:00

  • Education and coronary heart disease: mendelian randomisation study.

    abstract::Objective To determine whether educational attainment is a causal risk factor in the development of coronary heart disease.Design Mendelian randomisation study, using genetic data as proxies for education to minimise confounding.Setting The main analysis used genetic data from two large consortia (CARDIoGRAMplusC4D an...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.j3542

    authors: Tillmann T,Vaucher J,Okbay A,Pikhart H,Peasey A,Kubinova R,Pajak A,Tamosiunas A,Malyutina S,Hartwig FP,Fischer K,Veronesi G,Palmer T,Bowden J,Davey Smith G,Bobak M,Holmes MV

    更新日期:2017-08-30 00:00:00

  • Multicentre criterion based audit of the management of induced abortion in Scotland.

    abstract:OBJECTIVES:To assess and improve the quality of care provided to women undergoing induced abortion. DESIGN:Two rounds of prospective, criterion based case note review audit. SETTING:Ten NHS gynaecology units throughout Scotland. SUBJECTS:2004 patient episodes of abortion care identified consecutively during two roun...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.309.6946.15

    authors: Penney GC,Glasier A,Templeton A

    更新日期:1994-07-02 00:00:00

  • Effect of reducing total fat intake on body weight: systematic review and meta-analysis of randomised controlled trials and cohort studies.

    abstract:OBJECTIVE:To investigate the relation between total fat intake and body weight in adults and children. DESIGN:Systematic review and meta-analysis of randomised controlled trials and cohort studies. DATA SOURCES:Medline, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials to June 2010. INCLUSION CR...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.e7666

    authors: Hooper L,Abdelhamid A,Moore HJ,Douthwaite W,Skeaff CM,Summerbell CD

    更新日期:2012-12-06 00:00:00

  • Remembrance of conversations past: oral advance statements about medical treatment.

    abstract::Polls show increasing public interest in advance statements or directives about medical treatment ("living wills") but that few people, apart from Jehovah's Witnesses, carry such documents. Patients' firm, witnessed oral decisions are often sufficient to aid clinical decision making but should still be recorded in med...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6995.1663a

    authors: Sommerville A

    更新日期:1995-06-24 00:00:00