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Prior and subsequentto the publication of the third edition of the Diagnos tic and Statistical Manual of Mental Disorders (DSM-III), we have witnessed a considerable upsurge in the quantity and quality of research concerned with the psychiatric diagnostic process. There are several factors that have contributed to this empirical influx, including improved diagnostic cri teria for many psychiatric disorders, increased nosological attention to childhood psychopathology, and development and standardization of several structured diagnostic interview schedules for both adult and child populations. With the advent of DSM-III-R, and in anticipation of DSM-IV, diagnostic labels and their definitions have been in a state of change, as evinced by the many refinements and modifications currently taking place. However, the basic purpose or raison d'etre of the nosological scheme has not been altered. Psychiatric diagnosis is the means by which we classify or categorize human psychopathology. And, as is the case in the medical arena, psychiatric diagnosis serves three central functions: classification. communication. and prediction. As research accumulates, our understanding of psychiatric disorders increases, and we are in a much better position to classify reliably and with validity, as well as to com municate and predict Despite periodic changes in the diagnostic system, the basic strategies for conducting diagnostic research (e. g. , genetic-family studies, biological markers, follow-up studies, etc. ) do not vary appreciably over time. But in over one decade no scholarly book has appeared that tackles the essential research issues involved in upgrading the diagnostic endeavor.
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
This unique book presents a framework for the strategy and methodology of diagnostic research, in relation to its relevance for practice. Now in its second edition The Evidence Base of Clinical Diagnosis has been fully revised and extended with new chapters covering the STARD guidelines (STAndards for the Reporting of Diagnostic accuracy studies) and the multivariable analysis of diagnostic data. With contributions from leading international experts in evidence-based medicine, this book is an indispensable guide on how to conduct and interpret studies in clinical diagnosis. It will serve as a valuable resource for all investigators who want to embark on diagnostic research and for clinicians, practitioners and students who want to learn more about its principles and the relevant methodological options available.
Technology assessment can lead to the rapid application of essential diagnostic technologies and prevent the wide diffusion of marginally useful methods. In both of these ways, it can increase quality of care and decrease the cost of health care. This comprehensive monograph carefully explores methods of and barriers to diagnostic technology assessment and describes both the rationale and the guidelines for meaningful evaluation. While proposing a multi-institutional approach, it emphasizes some of the problems involved and defines a mechanism for improving the evaluation and use of medical technology and essential resources needed to enhance patient care.
Prior and subsequentto the publication of the third edition of the Diagnos tic and Statistical Manual of Mental Disorders (DSM-III), we have witnessed a considerable upsurge in the quantity and quality of research concerned with the psychiatric diagnostic process. There are several factors that have contributed to this empirical influx, including improved diagnostic cri teria for many psychiatric disorders, increased nosological attention to childhood psychopathology, and development and standardization of several structured diagnostic interview schedules for both adult and child populations. With the advent of DSM-III-R, and in anticipation of DSM-IV, diagnostic labels and their definitions have been in a state of change, as evinced by the many refinements and modifications currently taking place. However, the basic purpose or raison d'etre of the nosological scheme has not been altered. Psychiatric diagnosis is the means by which we classify or categorize human psychopathology. And, as is the case in the medical arena, psychiatric diagnosis serves three central functions: classification. communication. and prediction. As research accumulates, our understanding of psychiatric disorders increases, and we are in a much better position to classify reliably and with validity, as well as to com municate and predict Despite periodic changes in the diagnostic system, the basic strategies for conducting diagnostic research (e. g. , genetic-family studies, biological markers, follow-up studies, etc. ) do not vary appreciably over time. But in over one decade no scholarly book has appeared that tackles the essential research issues involved in upgrading the diagnostic endeavor.
Inviting the help of colleagues worldwide, the concise Diagnostic Issues in Substance Use Disorders is part of the new series Advancing the Research Agenda for DSM-V. Its 19 chapters by an international group of experts are designed to stimulate questions that will help guide research related to the development of the next editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and the International Classification of Diseases (ICD-11), with the goal of ensuring that the major substance use diagnoses represent the same condition in both references. They cover 10 major issues in three main sections: Overarching issues relevant for the development of international diagnostic systems -- statistical modeling techniques and whether DSM-V should use categorical and/or dimensional diagnostic approaches; methods review, emphasizing new hybrid techniques for developing and testing diagnostic concepts; the need for separate clinical and research-oriented diagnostic criteria, incorporating both categorical and dimensional attributes; neurobiological changes characterizing substance dependence; the importance of cultural attributes in developing definitions of substance use disorders; and the history of the development of diagnostic systems and how to optimize the "crosswalk" between DSM and ICD. Research questions more specific to the substance use disorders section of DSM -- comorbidity between substance use disorders and other psychiatric conditions, the relatively unique clinical course of substance-induced mental disorders and appropriate treatment approaches; the precision of the criteria and threshold for a diagnosis and how to improve them; the subtypes of substance use disorder, including how they have been derived and the extent to which they relate to neurobiological processes; the seemingly high prevalence of alcohol dependence in young people; suggested research questions to evaluate the application of diagnostic criteria to adolescents; and the specific psychoactive substances cannabis and nicotine. Whether substance use disorders should be included in a broader section termed "addictive disorders" -- impulse-control disorders (especially pathological gambling and the advantages and disadvantages of adding it to the current substance use disorders section), identifying research opportunities regarding their assessment and neurocognitive and physiological bases, discussing the specifics of the research agenda and how it might be implemented, and presenting questions generated by the research agenda developmental process. This informative compendium distills the findings of a wealth of recent research and concludes with recommendations for exploiting research opportunities that promise to inform decisions regarding DSM-V and other classification systems. As such, it will prove invaluable for clinicians and researchers everywhere.
v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.
The outlook for women with breast cancer has improved in recent years. Due to the combination of improved treatments and the benefits of mammography screening, breast cancer mortality has decreased steadily since 1989. Yet breast cancer remains a major problem, second only to lung cancer as a leading cause of death from cancer for women. To date, no means to prevent breast cancer has been discovered and experience has shown that treatments are most effective when a cancer is detected early, before it has spread to other tissues. These two facts suggest that the most effective way to continue reducing the death toll from breast cancer is improved early detection and diagnosis. Building on the 2001 report Mammography and Beyond, this new book not only examines ways to improve implementation and use of new and current breast cancer detection technologies but also evaluates the need to develop tools that identify women who would benefit most from early detection screening. Saving Women's Lives: Strategies for Improving Breast Cancer Detection and Diagnosis encourages more research that integrates the development, validation, and analysis of the types of technologies in clinical practice that promote improved risk identification techniques. In this way, methods and technologies that improve detection and diagnosis can be more effectively developed and implemented.
In its extensively revised and updated Second Edition, this book provides a solid foundation for readers interested in clinical research. Discussion encompasses genetic, pharmacoepidemiologic and implementation research. All chapters have been updated with new information and many new tables have been added to elucidate key points. The book now offers discussion on how to handle missing data when analyzing results, and coverage of Adaptive Designs and Effectiveness Designs and new sections on Comparative Effectiveness Research and Pragmatic Trials. Chapter 6 includes new material on Phase 0 Trials, expanded coverage of Futility Trials, a discussion of Medical Device approval, Off Label Drug use and the role of the FDA in regulating advertising. Additional new information includes the role of pill color and shape in association with the placebo effect and an examination of issues surrounding minority recruitment. The final chapter offers a new section on manuscript preparation along with a discussion of various guidelines being adopted by journals: CONSORT, STROBE, PRISMA, MOOSE and others; and coverage of Conflicts of Interest, Authorship, Coercive Citation, and Disclosures in Industry-Related Associations. Building on the strengths of its predecessor in its comprehensive approach and authoritative advice, the new edition offers more of what has made this book a popular, trusted resource for students and working researchers alike.
This is a comprehensive major reference work for our SpringerReference program covering clinical trials. Although the core of the Work will focus on the design, analysis, and interpretation of scientific data from clinical trials, a broad spectrum of clinical trial application areas will be covered in detail. This is an important time to develop such a Work, as drug safety and efficacy emphasizes the Clinical Trials process. Because of an immense and growing international disease burden, pharmaceutical and biotechnology companies continue to develop new drugs. Clinical trials have also become extremely globalized in the past 15 years, with over 225,000 international trials ongoing at this point in time. Principles in Practice of Clinical Trials is truly an interdisciplinary that will be divided into the following areas: 1) Clinical Trials Basic Perspectives 2) Regulation and Oversight 3) Basic Trial Designs 4) Advanced Trial Designs 5) Analysis 6) Trial Publication 7) Topics Related Specific Populations and Legal Aspects of Clinical Trials The Work is designed to be comprised of 175 chapters and approximately 2500 pages. The Work will be oriented like many of our SpringerReference Handbooks, presenting detailed and comprehensive expository chapters on broad subjects. The Editors are major figures in the field of clinical trials, and both have written textbooks on the topic. There will also be a slate of 7-8 renowned associate editors that will edit individual sections of the Reference.