6 results on '"Petitti DB"'
Search Results
2. Defining, Estimating, and Communicating Overdiagnosis in Cancer Screening.
- Author
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Davies L, Petitti DB, Woo M, and Lin JS
- Subjects
- Humans, Mammography, Early Detection of Cancer, Medical Overuse
- Published
- 2018
- Full Text
- View/download PDF
3. Defining, Estimating, and Communicating Overdiagnosis in Cancer Screening.
- Author
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Davies L, Petitti DB, Martin L, Woo M, and Lin JS
- Subjects
- Communication, Humans, Research Design standards, Statistics as Topic, Terminology as Topic, Early Detection of Cancer adverse effects, Early Detection of Cancer statistics & numerical data, Medical Overuse statistics & numerical data
- Abstract
The toll of inadequate health care is well-substantiated, but recognition is mounting that "too much" is also possible. Overdiagnosis represents one harm of too much medicine, but the concept can be confusing: It is often conflated with related harms (such as overtreatment, misclassification, false-positive results, and overdetection) and is difficult to measure because it cannot be directly observed. Because the U.S. Preventive Services Task Force (USPSTF) issues screening recommendations aimed largely at healthy persons, it has a particular interest in understanding harms related to screening, especially but not limited to overdiagnosis. In support of the USPSTF, the authors summarize the knowledge and provide guidance on defining, estimating, and communicating overdiagnosis in cancer screening. To improve consistency, thinking, and reporting about overdiagnosis, they suggest a specific definition. The authors articulate how variation in estimates of overdiagnosis can arise, identify approaches to estimating overdiagnosis, and describe best practices for communicating the potential for harm due to overdiagnosis.
- Published
- 2018
- Full Text
- View/download PDF
4. Update on the methods of the U.S. Preventive Services Task Force: insufficient evidence.
- Author
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Petitti DB, Teutsch SM, Barton MB, Sawaya GF, Ockene JK, and DeWitt T
- Subjects
- Decision Making, United States, Advisory Committees organization & administration, Evidence-Based Medicine methods, Health Services Research methods, Preventive Health Services
- Abstract
The U.S. Preventive Services Task Force (USPSTF) seeks to provide reliable and accurate evidence-based recommendations to primary care clinicians. However, clinicians indicate frustration with the lack of guidance provided by the USPSTF when the evidence is insufficient to make a recommendation. This article describes a new USPSTF plan to commission its Evidence-based Practice Centers to collect information in 4 domains pertinent to clinical decisions about prevention and to report this information routinely. The 4 domains are potential preventable burden, potential harm of the intervention, costs (both monetary and opportunity), and current practice. The process and rationale used to select these domains are presented, along with examples of how clinicians might use the information to guide clinical decision making when evidence is insufficient.
- Published
- 2009
- Full Text
- View/download PDF
5. Myocardial infarction and the use of estrogen and estrogen-progestogen in postmenopausal women.
- Author
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Sidney S, Petitti DB, and Quesenberry CP Jr
- Subjects
- Aged, California epidemiology, Case-Control Studies, Drug Therapy, Combination, Female, Humans, Incidence, Interviews as Topic, Middle Aged, Myocardial Infarction epidemiology, Odds Ratio, Postmenopause, Retrospective Studies, Risk Factors, Estrogen Replacement Therapy, Estrogens therapeutic use, Myocardial Infarction prevention & control, Progestins therapeutic use
- Abstract
Objective: To estimate the relative risk for incident acute myocardial infarction in relation to the current use of estrogen and estrogen-progestogen., Design: Retrospective case-control study., Setting: Medical centers of a large prepaid health care program, the Kaiser Permanente Medical Care Program (KPMCP), Northern California region., Participants: All women hospitalized at a KPMCP center for incident acute myocardial infarction during a 3-year period from 1991 to 1994. Controls were matched to case-patients for year of birth and KPMCP facility and were selected at random from among all female members of the KPMCP., Intervention: An in-person interview that included questions about current and lifetime use of estrogen and estrogen-progestogen; known cardiovascular risk factors; and other medical, sociodemographic and behavioral factors that might affect risk for myocardial infarction., Main Outcomes Measure: Odds ratios for myocardial infarction associated with use of estrogen and estrogen-progestogen., Results: The odds ratio for myocardial infarction in current users of estrogen or estrogen-progestogen compared with women who had never used these agents was 0.96 (95% CI, 0.66 to 1.40) after adjustment for confounders. The odds ratio for myocardial infarction in past users of estrogen or estrogen-progestogen was 1.07 (CI, 0.72 to 1.58). Duration of hormone use was unrelated to the odds ratio for myocardial infarction., Conclusions: This study did not show a statistically significant decrease in the odds ratio for myocardial infarction associated with current use of estrogen or estrogen-progestogen. It neither confirms nor refutes the hypothesis that hormone use prevents myocardial infarction in postmenopausal women.
- Published
- 1997
- Full Text
- View/download PDF
6. Hormone therapy to prevent disease and prolong life in postmenopausal women.
- Author
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Grady D, Rubin SM, Petitti DB, Fox CS, Black D, Ettinger B, Ernster VL, and Cummings SR
- Subjects
- Breast Neoplasms epidemiology, Cerebrovascular Disorders epidemiology, Coronary Disease epidemiology, Endometrial Neoplasms chemically induced, Female, Hip Fractures prevention & control, Humans, Middle Aged, Progestins administration & dosage, Risk Factors, Estrogen Replacement Therapy adverse effects
- Abstract
Purpose: To critically review the risks and benefits of hormone therapy for asymptomatic postmenopausal women who are considering long-term hormone therapy to prevent disease or to prolong life., Data Sources: Review of the English-language literature since 1970 on the effect of estrogen therapy and estrogen plus progestin therapy on endometrial cancer, breast cancer, coronary heart disease, osteoporosis, and stroke. We used standard meta-analytic statistical methods to pool estimates from studies to determine summary relative risks for these diseases in hormone users and modified lifetable methods to estimate changes in lifetime probability and life expectancy due to use of hormone regimens., Results: There is evidence that estrogen therapy decreases risk for coronary heart disease and for hip fracture, but long-term estrogen therapy increases risk for endometrial cancer and may be associated with a small increase in risk for breast cancer. The increase in endometrial cancer risk can probably be avoided by adding a progestin to the estrogen regimen for women who have a uterus, but the effects of combination hormones on risk for other diseases has not been adequately studied. We present estimates for changes in lifetime probabilities of disease and life expectancy due to hormone therapy in women who have had a hysterectomy; with coronary heart disease; and at increased risk for coronary heart disease, hip fracture, and breast cancer., Conclusions: Hormone therapy should probably be recommended for women who have had a hysterectomy and for those with coronary heart disease or at high risk for coronary heart disease. For other women, the best course of action is unclear.
- Published
- 1992
- Full Text
- View/download PDF
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