Low‐back pain (LBP) is a common condition seen in primary care. A principal aim during a clinical examination is to identify patients with a higher likelihood of underlying serious pathology, such as vertebral fracture, who may require additional investigation and specific treatment. All 'evidence‐based' clinical [...]
Our global medical culture has driven excessive diagnostic testing, overmedicalisation, and overtreatment across many conditions that may harm patients, exhaust healthcare resources, and harm the planet. The authors call upon local, national, and international decision makers to more prominently and openly acknowledge these issues and [...]
Privately funded spinal surgery rates continue to be larger than for publicly funded procedures, and they have also increased more rapidly. These differences may indicate that some privately funded procedures are unnecessary, or that the number of publicly funded procedures does not reflect clinical need.
Objectives: To report mastectomy and reoperation rates in women who had breast MRI for screening (S-MRI subgroup) or diagnostic (D-MRI subgroup) purposes, using multivariable analysis for investigating the role of MRI referral/nonreferral and other covariates in driving surgical outcomes.
Deciding whether it is worthwhile to advise older adults (aged ≥ 65 years) to continue or stop cancer screening is not straightforward for primary care practitioners (PCPs). At a population level, there is evidence that the benefit/harm trade-off of cancer screening becomes less favorable in older adults. The [...]
Consistent evidence shows pathology services are overused worldwide and that about one-third of testing is unnecessary. Audit and feedback (AF) is effective for improving care but few trials evaluating AF to reduce pathology test requesting in primary care have been conducted. The aim of this [...]
Population mammographic screening for breast cancer has led to large increases in the diagnosis and treatment of ductal carcinoma in situ (DCIS). Active surveillance has been proposed as a management strategy for low-risk DCIS to mitigate against potential overdiagnosis and overtreatment. However, clinicians and patients [...]
Since 2020, hundreds of thousands of more deaths than expected have been observed across the globe. Amid the coronavirus 2019 (COVID-19) pandemic, current research priorities are to control the spread of infection and minimise loss of life. However, there may be future opportunities to learn [...]
This review found robust evidence to inform discussion of possible recalibration of diagnostic thresholds, or use of alternative labels, for low-risk prostate cancer. RCTs and cohort studies demonstrate that active surveillance is a safe option for very low-risk and low-risk prostate cancers, with extremely low [...]
CTPA use increased from 2005 to 2015 while diagnostic yield amongst ED patients decreased. The PE hospitalization rate also increased, while the outcome of PE mortality remained constant. Although this study cannot prove that overuse occurred, increasing CTPA use with decreasing diagnostic yield suggests an [...]