Overdiagnosis in early detection programs
Overdiagnosis in early detection programs
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DOI：
10.1093/biostatistics/kxh012
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发表时间：
2004-10-01
期刊：
影响因子：
2.1
通讯作者：
Zelen, M
中科院分区：
文献类型：
--
作者：
Davidov, O;Zelen, M
过度诊断指的是筛查检查发现了一种疾病，而这种疾病在一个人的一生中是不会被发现的。这种疾病本来不会被诊断出来，因为这个人在临床发作之前就已经死于其他原因。虽然过度诊断的可能性是理解早期检测程序的一个重要量，但它尚未得到严格的研究。我们分析了一个理想化的早期检测方案，并推导出过度诊断概率的数学表达式。数值研究的结果为前列腺癌，并适用于各种筛查计划。我们的调查表明，过度诊断的可能性非常高。
Overdiagnosis refers to the situation where a screening exam detects a disease that would have otherwise been undetected in a person's lifetime. The disease would have not have been diagnosed because the individual would have died of other causes prior to its clinical onset. Although the probability of overdiagnosis is an important quantity for understanding early detection programs it has not been rigorously studied. We analyze an idealized early detection program and derive the mathematical expression for the probability of overdiagnosis. The results are studied numerically for prostate cancer and applied to a variety of screening schedules. Our investigation indicates that the probability of overdiagnosis is remarkably high.