H G Welch

..To describe changes in skin biopsy rates and to determine their relation with changes in the incidence of melanoma...

..Equally important, researchers need to work to develop better estimates of the magnitude of overdiagnosis and develop clinical strategies to help minimize it...

..Although the tendency to repeat examinations is a major determinant of the capacity to serve new patients and of the ability to contain health care costs, little research has described the patterns observed in actual practice...

..How cause of death is attributed in patients who die within 1 month of cancer-directed surgery is unknown...

..Systematic estimates of the number of men affected, however, to our knowledge, do not exist...

..evidence? Should they teach students that the burden of proof lies in demonstrating efficacy or in demonstrating ineffectiveness? And what should they tell students about when to seek evidence to aid diagnostic and treatment decisions?..

..We sought national estimates on the proportion of men found to have prostate cancer after a needle biopsy of the prostate and the risk of subsequent biopsies among those not found to have prostate cancer...

..Because diagnosis is typically thought of as purely a patient attribute, it is considered a critical factor in risk-adjustment policies designed to reward efficient and high-quality care...

..quot; Because other possibilities exist, we sought to determine how often lives were actually saved by mammography screening...

..5 ng/mL. We examined the effect of this lower threshold on the number of American men who would be labeled abnormal by a single PSA test...

..To determine women's attitudes to and knowledge of both false positive mammography results and the detection of ductal carcinoma in situ after screening mammography...

..The fractious public debate over mammography screening recommendations for women aged 40 to 49 years has received extensive attention in medical journals and in the press...

..To understand better how women perceive the chance of getting breast cancer, the authors asked women to estimate the risk in several ways. Each woman's answer was related to her actual risk...

..The exaggerated importance many attribute to a variety of controllable factors in modifying personal risk and the "danger" seen in failing to have mammograms may lead women diagnosed with breast cancer to blame themselves...

..To determine women's attitudes and knowledge of both false-positive mammography results and the detection of ductal carcinoma in situ after screening mammography...

..We evaluated the pattern of diagnostic testing following the initial FOBT in elderly Medicare beneficiaries. Such follow-up testing would in the long run influence both the cost and the benefit of widespread use of FOBT...

..Unfortunately, this fundamental information is not readily available to patients or physicians. We created simple one-page charts that present the 10-year chance of dying from various causes according to age, sex, and smoking status...

..However, increasing sulfa resistance among Escherichia coli may have led to changes in prescribing practices...

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..Changes in the diagnostic approach to thyroid nodules may have resulted in an increase in the apparent incidence of thyroid cancer...

..People are increasingly presented with medical statistics. There are no existing measures to assess their level of interest or confidence in using medical statistics...

..Cancer rates of the head and neck are traditionally linked to public health issues...

..To identify the trigger events that lead to the detection of otherwise asymptomatic thyroid cancers...

..To estimate rates of postpartum glucose tolerance testing in women diagnosed with gestational diabetes mellitus (GDM) and to assess factors associated with testing...

..Although there is now substantial evidence that pulmonary artery (PA) catheterization does not reduce mortality in critically ill patients, it is unknown whether national utilization has decreased in response...

..A steep increase in the incidence of esophageal adenocarcinoma has been observed between 1973 and 2001, but recent trends have not been reported. Our aim was to examine recent trends in esophageal adenocarcinoma incidence...

..To compare the survival rate of people with papillary thyroid cancer limited to the thyroid gland who have not had immediate, definitive treatment for their thyroid cancer with the survival rate of those who have had such treatment...

..To establish the reliability/validity of an 18-item test of patients' medical data interpretation skills...

..There are no data, however, regarding the frequency at which women actually undergo screening...

..In 1996, the US Preventive Services Task Force recommended that routine Papanicolaou (Pap) smear screening is unnecessary for these women...

..Although numerous studies suggest that there is an inverse relation between hospital volume of surgical procedures and surgical mortality, the relative importance of hospital volume in various surgical procedures is disputed...

..Perceptions of drug effectiveness were much lower for ads that incorporated the benefit box than for ads that did not. Most people we interviewed want benefit data in drug ads, can understand these data, and are influenced by them...

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..We sought to measure the tendency of primary care physicians to intervene across regions that differ in their levels of local health care spending...

..We aimed to characterize advertising by the nation's top academic medical centers...

..Surgical mortality rates are increasingly used to measure hospital quality. It is not clear, however, how many hospitals have sufficient caseloads to reliably identify quality problems...

..At least one-fourth of respondents who had seen or heard a celebrity endorsement said that the endorsement made them more likely to undergo mammography (25%), PSA testing (31%), or sigmoidoscopy or colonoscopy (37%)...

..There is growing interest in using C-reactive protein (CRP) levels to help select patients for lipid lowering therapy--although this practice is not yet supported by evidence of benefit in a randomized trial...

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..The introduction of screening mammography has been associated with sustained increases in breast cancer incidence. The natural history of these screen-detected cancers is not well understood...

..We sought to determine if hospitals with zero mortality over 3 years also have lower than average mortality in the subsequent year...

..Requiring ads to include a table with data on drug benefits and side effects (derived from clinical trials) could help, provided that consumers understand such tabular information...

..This enthusiasm creates an environment ripe for the premature diffusion of technologies such as total-body computed tomographic scanning, placing the public at risk of overtesting and overtreatment...

..In 1992, a randomized trial at one outpatient clinic demonstrated that making telephone appointments part of routine medical follow-up could save money and reduce hospitalization...

..Although many studies document problems with understanding risk information, few assess ways to teach interpretation skills...

..0, 2.1 to 4.3). CONCLUSION: Absolute risks are often not easily accessible in articles reporting ratio measures and sometimes are missing altogether-this lack of accessibility can easily exaggerate readers' perceptions of benefit or harm...

..We examine this assumption by determining the relative rate (RR) of elective AAA repair in black men vs white men after accounting for differences in disease prevalence...

..Patient factors accounted for only a small part of this variation. Although physicians responded to visits in predictable ways, each physician appeared to have a unique set point for the length of the revisits interval...

..These may, in turn, reflect the local "culture" in which they practice. How many patients providers are able to care for may be determined by the providers' inclinations toward the timing of follow-up visits...

..To isolate the effect of spoken language from financial barriers to care, we examined the relation of language to use of preventive services in a system with universal access...

..Physicians who order tests solely to improve patient satisfaction may be able to reduce unnecessary testing without decreasing patient satisfaction...

..Suggested intervals for postpolypectomy surveillance colonoscopy are currently based on the adenoma findings from the most recent examination...

..6 million to 4.0 million among women ages 50-64 (at a net cost of at least $18 billion). Whether or not offering treatment to these additional women will reduce the number of hip fractures is unknown...

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..We compared disease-specific and all-cause mortality in published randomized cancer-screening trials to indirectly assess the validity of the disease-specific mortality end point...

..An unintended consequence of starting new cardiac surgery programs is declining CABG hospital volume--a side effect that might increase mortality...

..It is not known how state newborn screening programs have changed screening practices in response to this technology and how it affects the number of false-positive test results...

..The entire process will be repeated on a cohort of men who receive a transurethral resection of the prostate. ..