Important note: Information in this article was accurate in 1983. The state of the art may have changed since the publication date.
EVALUATION OF DIAGNOSTIC PROCEDURES AND OTHER AIDS TO PATIENT MANAGEMENT
UICC Tech Rep Ser; 70:101-119 1982. Unique Identifier : AIDSLINE ICDB/82632340 Miller AB; Van der Schueren E; NCIC Epidemiology Unit, Univ. Toronto, Toronto, Canada
Abstract:
The necessary theoretical steps are described to ensure that a diagnostic procedure or other ancillary aid is both valid and reliable. An approach is described for further evaluation with regard to patient outcome using clinical trial methodology. A number of examples of diagnostic procedures or other aids to patient management are discussed that have been evaluated or require evaluation. Details of procedures are discussed in relation to staging in Hodgkin's disease, use of carcinoembryonic antigen, lymphangiograms in prostate cancer and cancer of the uterine cervix, hormone receptors, mammography, and other approaches including surgical operations used as diagnostic aids to staging determination or prognosis for further management. A dogma has crept up which indicates that only patients who are estrogen receptor (ER) positive should receive hormonal therapy whereas those who are ER negative should receive chemotherapy. In view of continuing controversy, it is unfortunate that such an approach has not been subjected, until now, to appropriate evaluation in controlled trials. Mammography is an example of a diagnostic procedure that has been challenged because of less than ideal sensitivity. In patients with an abnormality on physical examination of the breast, surgery may be delayed, with subsequent diagnosis of breast cancer. In some cases, the delay would not have occurred in the absence of the use of mammography. Randomized controlled trials may be used in evaluating other breast diagnostic procedures such as ultrasound, or if further perfected, computed axial tomographic scanning of the breast. (11 Refs)
Keywords: Breast Neoplasms/RADIOGRAPHY Carcinoembryonic Antigen/ANALYSIS Cervix Neoplasms/PATHOLOGY Clinical Trials Colonic Neoplasms/DIAGNOSIS Female Hodgkin's Disease/PATHOLOGY Human Laparotomy Lymphography Male Mammography Methods Neoplasm Staging/METHODS Neoplasms/*DIAGNOSIS/PATHOLOGY Prostatic Neoplasms/PATHOLOGY Splenectomy CLINICAL TRIAL JOURNAL ARTICLE REVIEW
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Important note: Information in this article was accurate in 1983. The state of the art may have changed since the publication date.
