Subject(s)
Biological Products/pharmacology , Glomerular Filtration Rate/drug effects , Psoriasis/drug therapy , Renal Insufficiency, Chronic/drug therapy , Adult , Aged , Biological Products/therapeutic use , Disease Progression , Female , Glomerular Filtration Rate/physiology , Humans , Male , Middle Aged , Psoriasis/complications , Renal Insufficiency, Chronic/etiology , Renal Insufficiency, Chronic/physiopathology , Retrospective Studies , Treatment OutcomeSubject(s)
Immunosuppressive Agents/adverse effects , Latent Tuberculosis/epidemiology , Skin Diseases/drug therapy , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Adult , Aged , Aged, 80 and over , Dermatology/standards , Female , Humans , Interferon-gamma Release Tests/statistics & numerical data , Latent Tuberculosis/diagnosis , Latent Tuberculosis/immunology , Male , Mass Screening/standards , Middle Aged , New Orleans/epidemiology , Practice Guidelines as Topic , Prevalence , Retrospective Studies , Skin Diseases/immunology , Tumor Necrosis Factor-alpha/immunologySubject(s)
Clinical Competence/statistics & numerical data , Dermatology/education , Skin Diseases/diagnosis , Skin Pigmentation/physiology , Students, Medical/statistics & numerical data , Dermatology/statistics & numerical data , Diagnostic Errors/prevention & control , Diagnostic Errors/statistics & numerical data , Education, Medical, Undergraduate/statistics & numerical data , Humans , Skin Diseases/physiopathologyABSTRACT
To examine how frequently and confidently healthy women report symptoms during surveillance for ovarian cancer. A symptoms questionnaire was administered to 24,526 women over multiple visits accounting for 70,734 reports. A query of reported confidence was included as a confidence score (CS). Chi square, McNemars test, ANOVA and multivariate analyses were performed. 17,623 women completed the symptoms questionnaire more than one time and >9500 women completed it more than one four times for >43,000 serially completed questionnaires. Reporting ovarian cancer symptoms was ~245 higher than ovarian cancer incidence. The positive predictive value (0.073%) for identifying ovarian cancer based on symptoms alone would predict one malignancy for 1368 cases taken to surgery due to reported symptoms. Confidence on the first questionnaire (83.3%) decreased to 74% when more than five questionnaires were completed. Age-related decreases in confidence were significant (p < 0.0001). Women reporting at least one symptom expressed more confidence (41,984/52,379 = 80.2%) than women reporting no symptoms (11,882/18,355 = 64.7%), p < 0.0001. Confidence was unrelated to history of hormone replacement therapy or abnormal ultrasound findings (p = 0.30 and 0.89). The frequency of symptoms relevant to ovarian cancer was much higher than the occurrence of ovarian cancer. Approximately 80.1% of women expressed confidence in what they reported.