Improving Diagnosis in Health Care
Improving Diagnosis in Health Care

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2015-12-29

Total Pages: 473

ISBN-13: 0309377722

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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.

Mammography and Beyond
Mammography and Beyond

Author: National Research Council

Publisher: National Academies Press

Published: 2001-07-23

Total Pages: 311

ISBN-13: 0309171318

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Each year more than 180,000 new cases of breast cancer are diagnosed in women in the U.S. If cancer is detected when small and local, treatment options are less dangerous, intrusive, and costly-and more likely to lead to a cure. Yet those simple facts belie the complexity of developing and disseminating acceptable techniques for breast cancer diagnosis. Even the most exciting new technologies remain clouded with uncertainty. Mammography and Beyond provides a comprehensive and up-to-date perspective on the state of breast cancer screening and diagnosis and recommends steps for developing the most reliable breast cancer detection methods possible. This book reviews the dramatic expansion of breast cancer awareness and screening, examining the capabilities and limitations of current and emerging technologies for breast cancer detection and their effectiveness at actually reducing deaths. The committee discusses issues including national policy toward breast cancer detection, roles of public and private agencies, problems in determining the success of a technique, availability of detection methods to specific populations of women, women's experience during the detection process, cost-benefit analyses, and more. Examining current practices and specifying research and other needs, Mammography and Beyond will be an indispensable resource to policy makers, public health officials, medical practitioners, researchers, women's health advocates, and concerned women and their families.

Evolution of Translational Omics
Evolution of Translational Omics

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2012-09-13

Total Pages: 354

ISBN-13: 0309224187

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Technologies collectively called omics enable simultaneous measurement of an enormous number of biomolecules; for example, genomics investigates thousands of DNA sequences, and proteomics examines large numbers of proteins. Scientists are using these technologies to develop innovative tests to detect disease and to predict a patient's likelihood of responding to specific drugs. Following a recent case involving premature use of omics-based tests in cancer clinical trials at Duke University, the NCI requested that the IOM establish a committee to recommend ways to strengthen omics-based test development and evaluation. This report identifies best practices to enhance development, evaluation, and translation of omics-based tests while simultaneously reinforcing steps to ensure that these tests are appropriately assessed for scientific validity before they are used to guide patient treatment in clinical trials.

The Drug Development Paradigm in Oncology
The Drug Development Paradigm in Oncology

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2018-02-12

Total Pages: 145

ISBN-13: 0309457971

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Advances in cancer research have led to an improved understanding of the molecular mechanisms underpinning the development of cancer and how the immune system responds to cancer. This influx of research has led to an increasing number and variety of therapies in the drug development pipeline, including targeted therapies and associated biomarker tests that can select which patients are most likely to respond, and immunotherapies that harness the body's immune system to destroy cancer cells. Compared with standard chemotherapies, these new cancer therapies may demonstrate evidence of benefit and clearer distinctions between efficacy and toxicity at an earlier stage of development. However, there is a concern that the traditional processes for cancer drug development, evaluation, and regulatory approval could impede or delay the use of these promising cancer treatments in clinical practice. This has led to a number of effortsâ€"by patient advocates, the pharmaceutical industry, and the Food and Drug Administration (FDA)â€"to accelerate the review of promising new cancer therapies, especially for cancers that currently lack effective treatments. However, generating the necessary data to confirm safety and efficacy during expedited drug development programs can present a unique set of challenges and opportunities. To explore this new landscape in cancer drug development, the National Academies of Sciences, Engineering, and Medicine developed a workshop held in December 2016. This workshop convened cancer researchers, patient advocates, and representatives from industry, academia, and government to discuss challenges with traditional approaches to drug development, opportunities to improve the efficiency of drug development, and strategies to enhance the information available about a cancer therapy throughout its life cycle in order to improve its use in clinical practice. This publication summarizes the presentations and discussions from the workshop.

Improving and Accelerating Therapeutic Development for Nervous System Disorders
Improving and Accelerating Therapeutic Development for Nervous System Disorders

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2014-02-06

Total Pages: 107

ISBN-13: 0309292492

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Improving and Accelerating Therapeutic Development for Nervous System Disorders is the summary of a workshop convened by the IOM Forum on Neuroscience and Nervous System Disorders to examine opportunities to accelerate early phases of drug development for nervous system drug discovery. Workshop participants discussed challenges in neuroscience research for enabling faster entry of potential treatments into first-in-human trials, explored how new and emerging tools and technologies may improve the efficiency of research, and considered mechanisms to facilitate a more effective and efficient development pipeline. There are several challenges to the current drug development pipeline for nervous system disorders. The fundamental etiology and pathophysiology of many nervous system disorders are unknown and the brain is inaccessible to study, making it difficult to develop accurate models. Patient heterogeneity is high, disease pathology can occur years to decades before becoming clinically apparent, and diagnostic and treatment biomarkers are lacking. In addition, the lack of validated targets, limitations related to the predictive validity of animal models - the extent to which the model predicts clinical efficacy - and regulatory barriers can also impede translation and drug development for nervous system disorders. Improving and Accelerating Therapeutic Development for Nervous System Disorders identifies avenues for moving directly from cellular models to human trials, minimizing the need for animal models to test efficacy, and discusses the potential benefits and risks of such an approach. This report is a timely discussion of opportunities to improve early drug development with a focus toward preclinical trials.

Radiology in Global Health
Radiology in Global Health

Author: Daniel J. Mollura

Publisher: Springer

Published: 2014-07-02

Total Pages: 273

ISBN-13: 1461406048

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The World Health Organization stated that approximately two-thirds of the world’s population lacks adequate access to medical imaging. The scarcity of imaging services in developing regions contributes to a widening disparity of health care and limits global public health programs that require imaging. Radiology is an important component of many global health programs, including those that address tuberculosis, AIDS-related disease, trauma, occupational and environmental exposures, breast cancer screening, and maternal-infant health care. There is a growing need for medical imaging in global health efforts and humanitarian outreach, particularly as an increasing number of academic, government, and non-governmental organizations expand delivery of health care to disadvantaged people worldwide. To systematically deploy clinical imaging services to low-resource settings requires contributions from a variety of disciplines such as clinical radiology, epidemiology, public health, finance, radiation physics, information technology, engineering, and others. This book will review critical concepts for those interested in managing, establishing, or participating in a medical imaging program for resource-limited environments and diverse cross-cultural contexts undergoing imaging technology adaptation.

Evaluation of Biomarkers and Surrogate Endpoints in Chronic Disease
Evaluation of Biomarkers and Surrogate Endpoints in Chronic Disease

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2010-06-25

Total Pages: 335

ISBN-13: 0309157277

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Many people naturally assume that the claims made for foods and nutritional supplements have the same degree of scientific grounding as those for medication, but that is not always the case. The IOM recommends that the FDA adopt a consistent scientific framework for biomarker evaluation in order to achieve a rigorous and transparent process.

Visceral and Ectopic Fat
Visceral and Ectopic Fat

Author: Hildo J. Lamb

Publisher: Elsevier

Published: 2022-10-15

Total Pages: 422

ISBN-13: 0128221860

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While the health consequences and mechanisms by which visceral fat causes disease are well-studied, relatively less is known about ectopic fat, its patterns of deposition and its effects on the pathoetiology of type 2 diabetes, atherosclerosis, and cardiovascular disease. Visceral and Ectopic Fat: Risk Factors for Type 2 Diabetes, Atherosclerosis, and Cardiovascular Disease covers the wealth of literature that has been amassed over the past decade on this topic. This reference brings all the research and clinical data together in one volume and helps clinicians and academic researchers understand more thoroughly the underlying mechanisms and interrelation between fat depots and ectopic fat stores in relation to health and disease. It showcases some of the recent developments in adipose tissue biology, particularly on the impact of interventional strategies - bariatric surgery, liposuction, physical and dietary intervention - of which information is desired among health specialists and policy makers. Brings together up-to-date research on imaging, genetics, and risk factors for chronic diseases such as diabetes, heart disease, cancer, and fatty liver disease Takes a deep dive into the current state of knowledge regarding fat stores, ectopic fat, regulation of fat stores, clinical implications, interventions, and imagining techniques Provides up-to-date information specifically focused on visceral and ectopic fat. In addition, both pathophysiological and preventive and treatment aspects of the problem will be considered Covers a broad range of organs - different fat stores such as skeletal muscle, bone marrow, liver and kidney Discusses potential interventions to reduce abdominal fat