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Patient age, time of day, and supplement use influence screening results; repeat testing is advised. Avoid treating to improve mood, cognition, fatigue, or quality of life. Subclinical hypothyroidism (SCH) is [...]

In this issue of JFP, Smith et al recommend following guidelines from the American Academy of Pediatrics to annually screen children for hypertension (see page 220). This recommendation appears to [...]

* OBJECTIVES To determine whether the use of a symptom severity measure to augment an existing Diagnostic and Statistical Manual of Mental Disorders--Third Edition, Revised (DSM-III-R) criteria-based depression screener (PRIME-MD) [...]

BACKGROUND. The use of serum chemistry panels as screening tests has been studied in a variety of clinical and nonclinical settings. None of the studies, however, has attempted to carefully [...]

BACKGROUND. Brief interventions with problem drinkers have been shown to be effective, but physicians often do not ask about alcohol use. If a single question could effectively screen for problem [...]

BACKGROUND. It is common practice to routinely screen pregnant women for gestational diabetes. The screening technique typically used is the 1-hour 50-g oral glucose tolerance test (OGTT), with a subsequent [...]

Background. The incidence of cutaneous malignant melanoma is steadily rising. Although cancer screening guidelines seek to increase the frequency of curative early excision of melanomas, it is unclear how these [...]

The identification of strategies for the prevention, diagnosis, and treatment of cancer is a high priority for the nation. It is estimated that $10 billion is spent each year for [...], Background. The identification of effective strategies for the prevention, diagnosis, and treatment of cancer is a high priority for the nation, yet relatively little is known about how cancer is diagnosed in primary care. This study was undertaken to describe practitioner beliefs about cancer screening and to determine whether beliefs and intentions about cancer screening are associated with actual cancer detection rates among asymptomatic patients cared for by family physicians. Methods. A self-administered questionnaire on cancer screening beliefs and practices was completed by members of the Michigan Research Network (MIRNET) in January 1990 and again in December of 1990. Thirty-one practitioners prospectively identified all patients with a new diagnosis of cancer during 1990. Results. One hundred sixteen cancer cases were identified. Only 31% of the 77 cancers considered to be potentially detectable by routine screening were actually identified by screening. Physicians reporting more aggressive screening practices identified greater percentages of asymptomatic cancers and a greater number of breast and colon cancers. Conclusions. Low percentages of cancers were detected in asymptomatic patients in this population. Practitioner attitudes about the need for cancer screening appear to be an important component of cancer detection. Key words. Family medicine; cancer; diagnostic tests, routine. (J Fam Perfect 1995; 40:27-33)

Background. The objectives of this study were (1) to estimate the prevalence of previously unknown diabetes mellitus in an apparently healthy population aged 40 years and older, (2) to estimate [...]

After 5 years of gradual decline, the incidence of primary and secondary syphilis in the United States increased 23% in the first quarter of 1987. [1] The greatest numerical increases [...]

The poor results of cancer screening have been previously documented. Several ways of improving the effectiveness of cancer screening have had limited to moderate success. Reminders mailed to patients have shown some rate of success. Studies on the effectiveness of printed patient education material on cancer screening testing has been limited, except in the area of breast self-examination. In this study of 178 asymptomatic women, the effectiveness of a recall letter containing patient education material is reported. A letter was sent to 102 patients; a control group of 76 patients were not contacted. The letter was sent by patient's physician and recommended that specific cancer screening tests be performed. The letter explained the general risk factors for the cancer, the reasons for the tests, and cost and risk of the tests. A follow-up letter was sent four weeks later. An audit was completed within four months to determine if the screening tests had been performed. The results indicated that the letter had no effect on the percent of patients who underwent screening tests. In fact, there was an adverse effect was seen on the average number of screening tests performed. The study group was then divided into compliers, those who had undergone screening before the study period, and noncompliers. The recall letter had no impact on the noncompliers, and a negative effect was observed in the complier group. It appears that it is ill-advised for family physicians to use routine recall for cancer screening in asymptomatic patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

The National Cholesterol Education Program (NCEP) has established guidelines for detecting, evaluating, and treating elevated blood cholesterol levels in adults. The program has been endorsed by 24 medical organizations nationwide. However, it is estimated that the cost of screening of all adults will be greater than $12 billion. This does not include the cost of treating and monitoring the estimated 117 million patients who will be identified. The repercussions of this program are considered. Interpretation of the results of screening is complicated and variations among laboratories may occur. The initial impetus for creating the NCEP was the evidence of decreased incidence of nonfatal myocardial infarction (heart attack) in patients treated for elevated serum cholesterol levels. However, the patients who were treated showed a trend for increased stomach and bowel cancer. The population studied were middle-aged men; women have a lower morbidity from heart disease. Also, elevated cholesterol levels in the elderly do not predict heart disease or death. The value of universal cholesterol testing is questioned. After careful review of the evidence, some have recommended that testing and treatment for elevated cholesterol should be individualized. In the United Kingdom, the Royal College of Physicians has rejected the concept of universal screening, and the Committee on Nutrition 1988-1989 has recommended against universal cholesterol testing in children. The minor decrease in morbidity seen in middle-aged men treated for elevated cholesterol does not appear to balance the costs and possible harm to patients, physicians, and the general public. Medical organizations should reconsider their endorsement of NCEP. (Consumer Summary produced by Reliance Medical Information, Inc.)

TO THE EDITOR: I read with interest the articles by Lavery and Gazewood and by Mayfield and Sugarman in the November 2000 supplement to JFP.[1,2] The authors recommend regular screening [...]

Implications of Using Administrative Data * BACKGROUND Large health care organizations may use administrative data to target primary care patients with depression for quality improvement (QI) activities. However, little is [...]

Transmission of hepatitis B virus (HBV) from an asymptomatic chronic carrier mother to her newborn infant has been shown to result in acute neonatal hepatitis and in long-term serious liver [...]

The intrauterine curette was invented in 1843 and shortly thereafter declared too dangerous for practical use. (1) From this dubious beginning, endometrial sampling has become a common office-based procedure with [...]

Each month, the POEMs editorial team reviews more than 80 journals of interest to primary care physicians, identifying the articles you have to know about to stay up to date. [...]

* Clinical Question Are current methods of routine screening for developmental dysplasia of the hip effective in preventing adverse outcomes? * Bottom Line Routine screening of newborns using the Barlow [...]