An unmeasured harm of screening
Cette étude évalue l'impact, sur une population d'hommes relevant du système d'assurance maladie Medicare, de recommandations émises en 2088 par un groupe d'experts américains en défaveur du dépistage du cancer de la prostate à l'aide du PSA
Mr R was such a patient. A 65-year-old, obese former smoker with a history of myocardial infarction and persistent risk factors (hypertension and hyperlipidemia), Mr R had undergone a total knee arthroplasty at age 60 years because of osteoarthritis. Thereafter, he was able to walk a mile at a stretch but could go no further because of persistent joint pain. A veteran of Vietnam, Mr R underwent screening ultrasonography for AAA when the clinical reminder system of the US Department of Veterans Affairs prompted his primary care physician. He was found to have an aneurysm of 6.0 × 4.7 cm on the ultrasonogram. Mr R's primary care physician discussed the case with a vascular surgeon, who recommended a follow-up computed tomography (CT) scan with contrast and prompt follow-up in the vascular clinic.
Archives of Internal Medicine , commentaire en libre accès, 2011