Downstream Breast Imaging Following Screening Mammography in Medicare Patients with Advanced Cancer: A Population-Based Study

Sadigh, Gelareh; Duszak, Richard; Ward, Kevin C.; Jiang, Renjian; Switchenko, Jeffrey M.; Applegate, Kimberly E.; Carlos, Ruth C.

doi:10.1007/s11606-017-4212-x

Cited by 4 publications

(3 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Breast malignancies are a leading cause of cancer mortality in women and their screening and diagnosis constitute significant imaging volume. However, current practices of screening fall short of maximizing benefits for patients and reducing waste [14][15][16] . Similarly, mastalgia is a common complaint experienced by up to 70% of women in their lifetime 17 .…”

Section: Introductionmentioning

confidence: 99%

Evaluating ChatGPT as an Adjunct for Radiologic Decision-Making

Rao¹,

Kim²,

Kamineni³

et al. 2023

Preprint

169

110

View full text Add to dashboard Cite

BACKGROUND ChatGPT, a popular new large language model (LLM) built by OpenAI, has shown impressive performance in a number of specialized applications. Despite the rising popularity and performance of AI, studies evaluating the use of LLMs for clinical decision support are lacking. PURPOSE To evaluate ChatGPT′s capacity for clinical decision support in radiology via the identification of appropriate imaging services for two important clinical presentations: breast cancer screening and breast pain. MATERIALS AND METHODS We compared ChatGPT′s responses to the American College of Radiology (ACR) Appropriateness Criteria for breast pain and breast cancer screening. Our prompt formats included an open-ended (OE) format, where ChatGPT was asked to provide the single most appropriate imaging procedure, and a select all that apply (SATA) format, where ChatGPT was given a list of imaging modalities to assess. Scoring criteria evaluated whether proposed imaging modalities were in accordance with ACR guidelines. RESULTS ChatGPT achieved an average OE score of 1.83 (out of 2) and a SATA average percentage correct of 88.9% for breast cancer screening prompts, and an average OE score of 1.125 (out of 2) and a SATA average percentage correct of 58.3% for breast pain prompts. CONCLUSION Our results demonstrate the feasibility of using ChatGPT for radiologic decision making, with the potential to improve clinical workflow and responsible use of radiology services.

show abstract

Section: Introductionmentioning

confidence: 99%

Evaluating ChatGPT as an Adjunct for Radiologic Decision-Making

Rao¹,

Kim²,

Kamineni³

et al. 2023

Preprint

169

110

View full text Add to dashboard Cite

show abstract

“…3,4 The first, by Sadigh et al, examined use of mammography screening among 34,127 female Medicare beneficiaries aged 65-108 who were newly diagnosed with advanced lung or colorectal cancer between 2000 and 2011. They found that 9% of these women had a screening mammogram after diagnosis, despite the fact that advanced lung and colorectal cancer both have an overall 5-year survival of less than 20%.…”

mentioning

confidence: 99%

Overutilization of Breast Cancer Screening in the US: Awareness of a Growing Problem

Schonberg

2017

J GEN INTERN MED

View full text Add to dashboard Cite

“…Sadigh et al found that many women with advanced cancer undergo mammography and resultant additional testing.…”

Section: Resultsmentioning

confidence: 99%

2019 Update on Medical Overuse

et al. 2019

View full text Add to dashboard Cite

edical overuse has gained traction in the national health care conversation. 1 In the United States, deeper understanding about the contributions of medical overuse to the opioid epidemic 2,3 has led to reduced prescribing by practitioners. The public is also learning about harms from inappropriate use of medical devices through articles that detail large investigations, 4 books, 5 and even film. 6 The burgeoning public conversation about overuse has been accompanied by continued efforts within the medical community to address it. Initiatives have included professional meetings (such as the Preventing Overdiagnosis 7 and High Value Practice Academic Alliance conferences) 8 ; quality improvement initiatives at the institutional, payer, and state levels 9,10 ; and targeted collections in medical journals, such as the Less is More series in JAMA Internal Medicine. The present series of updates in overuse in adult medicine [11][12][13][14][15] has given rise to updates in pediatric [16][17][18] and dermatology overuse (unpublished data, Arash Mostaghimi, Ashley Pournamdari, Elizabeth Tkachenko, John Barbieri, and Adewole Adamson, 2019). Additional consequences of overuse receiving attention is how overuse affects practitioners. A 2018 survey 19 of physicians, nurses, and advanced practice practitioners found that self-reported provision of inappropriate or futile care was common and associated with burnout. This finding replicated previous studies of critical care practitioners 20,21 and implies that reducing overuse could enhance practitioner wellness. 19 This article examines and describes 10 of the most important studies published in 2018 concerning medical overuse in the care of adult patients. We divided the articles into the following categories: overtesting, overdiagnosis, services to question, and methods to reduce overuse. IMPORTANCE Medical overuse is an important cause of patient harm and medical waste.OBSERVATION This structured literature review of English-language articles supplemented by examination of tables of contents of high-impact journals published in 2018 identified articles related to medical overuse. Articles were appraised for their methodologic quality, clinical relevance, and influence on patients. Of 1499 candidate articles, 839 addressed medical overuse. Of these, 117 were deemed to be most significant, with the 10 highestranking articles selected by author consensus. The most important articles on medical overuse identified issues with testing, including that procalcitonin does not affect antibiotic duration in patients with lower respiratory tract infection (4.2 vs 4.3 days); incidentalomas are present in 22% to 38% of common magnetic resonance imaging or computed tomography studies; 9% of women dying of stage IV cancer are still screened with mammography; and computed tomography lung cancer screening offers stable benefit and higher rates of harm for patients at lower risk. Articles related to overtreatment reported that urgent care clinics commonly overprescribe antibiotics (in 39% of...

show abstract

Downstream Breast Imaging Following Screening Mammography in Medicare Patients with Advanced Cancer: A Population-Based Study

Abstract: Among women with advanced colorectal and lung cancer, 9% continued screening mammography, and 11% of these screening studies led to at least one additional downstream test, resulting in costs with little likelihood of meaningful benefit.

Cited by 4 publications

References 24 publications

Evaluating ChatGPT as an Adjunct for Radiologic Decision-Making

Evaluating ChatGPT as an Adjunct for Radiologic Decision-Making

Overutilization of Breast Cancer Screening in the US: Awareness of a Growing Problem

2019 Update on Medical Overuse

Contact Info

Product

Resources

About