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Cancer screening is a prominent strategy in cancer control in the United States, yet the ability to correctly interpret cancer screening data eludes many researchers, clinicians, and policy makers. This open access primer rectifies that situation by teaching readers, in simple language and with straightforward examples, why and how the population-level cancer burden changes when screening is implemented, and how we assess whether that change is of benefit. This book provides an in-depth look at the many aspects of cancer screening and its assessment, including screening phenomena, performance measures, population-level outcomes, research designs, and other important and timely topics. Concise, accessible, and focused, Assessment of Cancer Screening: A Primer is best suited to those with education or experience in clinical research or public health in the United States - no previous knowledge of cancer screening assessment is necessary. This is the first text dedicated to cancer screening theory and methodology to be published in 20 years.
Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.
This book is a unique resource on the influence cancer and cancer treatments have on cognition. The majority of cancer patients on active treatment experience cognitive impairments often referred to as 'chemobrain' or 'chemofog'. In addition, patients with primary or metastatic tumors of the brain often experience direct neurologic symptoms. This book helps health care professionals working with cancer patients who experience cognitive changes and provides practical information to help improve care by reviewing and describing brain-behavior relationships; research-based evidence on cognitive changes that occur with various cancers and cancer treatments; assessment techniques, including neurocognitive assessment and neuroimaging techniques; and intervention strategies for affected patients. In short, it will explain how to identify, assess and treat these conditions.
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 study investigated criterion-related validity and measurement bias of three self-report measures of physical activity among women diagnosed with breast cancer. The 7-Day Physical Activity Recall (PAR), the International Physical Activity Questionnaire (IPAQ), and the physical activity items developed by the Women's Health Initiative (WHI-Q) were compared. The study was conducted at the University of California, San Diego study site among Women's Healthy Eating and Living Study participants. Women (N = 159, average age 57 years) wore an accelerometer for one week and then completed the WHI-Q and were administered by telephone either the IPAQ or PAR. Time spent in moderate, vigorous and total physical activity was obtained from accelerometer and self-report measures. Criterion-related validity was evaluated as the Spearman rank-order correlation between accelerometer and self-report score. The proportion meeting the American College of Sports Medicine physical activity guideline (Pate et al., 1995) by self-report measure was compared to accelerometer and screening statistics computed. Measurement bias was defined as self-report minus accelerometer score; this bias could be either an over-estimate or an under-estimate of physical activity. The correlation coefficients for the PAR and WHI-Q moderate and total physical activity scores were highest (.65 to .73) compared to the IPAQ (.26 and .33). Vigorous score correlations did not differ by self-report measure (.47 to .59). The PAR had the highest sensitivity (100%) and specificity (84%) compared to the other measures. Moderate physical activity was over-estimated on the IPAQ by 239% (225 min/week) compared to 11% on the PAR. Over-reporting of vigorous physical activity on the WHI-Q was associated with increasing body mass index. Increasing under-reporting of moderate and total physical activity was associated with decreasing age on all measures but with body mass index on the WHI-Q only. Social desirability was not significantly associated with measurement bias. The study found clear differences between the self-report measures: the WHI-Q was comparable in validity to the PAR while the IPAQ had lower validity and also significant over-estimates of moderate physical activity. Using the accelerometer as the criterion against which self-report scores were compared was discussed as a limitation of this investigation.