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Nonconcordance between Clinical and Head CT Findings : The Specter of Overdiagnosis
Joint Authors
Mower, William R.
Merchant, Guy
Zucker, Michael I.
Gabayan, Gelareh Z.
Iqbal, Erum
Lopez-Freeman, Roberto A.
Hoffman, Jerome R.
O'Laughlin, Kelli N.
Go, Steven
Source
Emergency Medicine International
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-10-01
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Background.
It is unclear whether history and physical examination findings can predict abnormalities on head computed tomography (CT) believed to indicate increased risk of lumbar-puncture- (LP-) induced brain herniation.
The objectives of this study were to (1) identify head CT findings felt to be associated with increased risk of brain herniation and (2) to assess the ability of history and physical examination to predict those findings.
Methods.
Using a modified Delphi survey technique, an expert panel defined CT abnormalities felt to predict increased risk of LP-induced brain herniation.
Presence of such findings on CT was compared with history and physical examination (H&P) variables in 47 patients.
Results.
No H&P variable predicted “high-risk” CT; combining H&P variables to improve sensitivity led to extremely low specificity and still failed to identify all patients with high-risk CT.
Conclusions.
“High-risk” CT is not uncommon in patients with clinical characteristics known to predict an absence of actual risk from LP, and thus it may not be clinically relevant.
“Overdiagnosis” will be increasingly problematic as technological advances identify increasingly subtle deviations from “normal.”
American Psychological Association (APA)
O'Laughlin, Kelli N.& Hoffman, Jerome R.& Go, Steven& Gabayan, Gelareh Z.& Iqbal, Erum& Merchant, Guy…[et al.]. 2013. Nonconcordance between Clinical and Head CT Findings : The Specter of Overdiagnosis. Emergency Medicine International،Vol. 2013, no. 2013, pp.1-7.
https://search.emarefa.net/detail/BIM-462770
Modern Language Association (MLA)
O'Laughlin, Kelli N.…[et al.]. Nonconcordance between Clinical and Head CT Findings : The Specter of Overdiagnosis. Emergency Medicine International No. 2013 (2013), pp.1-7.
https://search.emarefa.net/detail/BIM-462770
American Medical Association (AMA)
O'Laughlin, Kelli N.& Hoffman, Jerome R.& Go, Steven& Gabayan, Gelareh Z.& Iqbal, Erum& Merchant, Guy…[et al.]. Nonconcordance between Clinical and Head CT Findings : The Specter of Overdiagnosis. Emergency Medicine International. 2013. Vol. 2013, no. 2013, pp.1-7.
https://search.emarefa.net/detail/BIM-462770
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-462770