The Prostate-specific tests of the antigen (PSA) to the screen for the cancer of the prostate are made frequently between the patients for those who the test of PSA is not demonstrated to be beneficial, and the clinical ones with certain characteristics are more probable to request such inadequate tests of investigation, according to a report in the application of the 9 of July archives of the internal medicine, one of newspapers of JAMA/Archives. Most of the guidelines for the clinical practice they do not recommend the investigation routine of PSA for the men youngest of 40, older of 75 or it is hoped that who live than 10 years less, according to the information of bottom in the article. “To our knowledge, he does not have at the moment demonstrates solid that the investigation of PSA provides any subsidy by disease for these patient populations,” the authors write. “Something, imposes substantial psychological and financial costs and can lead to the therapeutic procedures of diagnosis and of the questionable advantage.” Because the last decision to make rest of test of PSA with clinical, it is probable that demographic and other characteristics of doctors, nurses and assistants of the doctor can influence inadequate behaviors of the investigation. B. To appraise Kerfoot, M.D., Ed.M., of the system of Boston Healthcare of the subjects of the veterans and the medical school of Harvard, the Boston, and the analyzed data the colleagues from 105,765 masculine patients who were dealed with in the facilities of the subjects the health of the veterans (VHA) in the New England as of 1997 to 2004. The information on the patients and the 1,552 clinical ones of the medical care who requested PSA tests was compiled of data bases of VHA. The inadequate investigation was defined as PSA that proved in the patients oldest of 75 or younger from 40 who it had not been diagnosed with the cancer of the prostate, it did not take to cancer from the prostate specific medications nor had experienced related procedures. Of the 232,302 tests of PSA requested during the period of the study, 37,483 (16,1 percents) were considered inadequate, with (15,3 percents) made in 35,612 patients older of 75 years and 1,871 (0,8 percent) in patients younger of 40 years. Of the clinical ones of the medical care that requested inadequate tests, 51,3 percents were masculine, 79,4 percents were doctors, 53,4 percents were doctors of the apprentice and 8,2 percents were urólogos. The “doctors who were specialistic of the urología, man, orderers of the PSA tests and affiliated infrequent with the specific hospitals had levels perceivably more stops of the inadequate investigation of PSA. Compared with taking care of doctors, the nurses and the assistants of the doctor perceivably had inferior levels of the inadequate investigation,” the authors write. “The percentage of the inadequate investigation of PSA increased perceivably with the age of the masculine suppliers of the medical care,” they continues. “The cause of these the differences of sex and the age is not clear. It is possible that, as they age, the masculine suppliers of the medical care empathize more and more with his excessive preoccupations of the cancer of the prostate of older masculine patients. His “prostatemphathy” can then lead to one more a more aggressive investigation in these older masculine patients.” The patient changes of the education and the system-level, such as an automated system that it could alert when clinical they try to request an inadequate test of PSA, could help to reduce the level of the erroneous use of the investigation of PSA, the authors conclude.Sunday, July 22, 2007
The Prostate Problems
The Prostate-specific tests of the antigen (PSA) to the screen for the cancer of the prostate are made frequently between the patients for those who the test of PSA is not demonstrated to be beneficial, and the clinical ones with certain characteristics are more probable to request such inadequate tests of investigation, according to a report in the application of the 9 of July archives of the internal medicine, one of newspapers of JAMA/Archives. Most of the guidelines for the clinical practice they do not recommend the investigation routine of PSA for the men youngest of 40, older of 75 or it is hoped that who live than 10 years less, according to the information of bottom in the article. “To our knowledge, he does not have at the moment demonstrates solid that the investigation of PSA provides any subsidy by disease for these patient populations,” the authors write. “Something, imposes substantial psychological and financial costs and can lead to the therapeutic procedures of diagnosis and of the questionable advantage.” Because the last decision to make rest of test of PSA with clinical, it is probable that demographic and other characteristics of doctors, nurses and assistants of the doctor can influence inadequate behaviors of the investigation. B. To appraise Kerfoot, M.D., Ed.M., of the system of Boston Healthcare of the subjects of the veterans and the medical school of Harvard, the Boston, and the analyzed data the colleagues from 105,765 masculine patients who were dealed with in the facilities of the subjects the health of the veterans (VHA) in the New England as of 1997 to 2004. The information on the patients and the 1,552 clinical ones of the medical care who requested PSA tests was compiled of data bases of VHA. The inadequate investigation was defined as PSA that proved in the patients oldest of 75 or younger from 40 who it had not been diagnosed with the cancer of the prostate, it did not take to cancer from the prostate specific medications nor had experienced related procedures. Of the 232,302 tests of PSA requested during the period of the study, 37,483 (16,1 percents) were considered inadequate, with (15,3 percents) made in 35,612 patients older of 75 years and 1,871 (0,8 percent) in patients younger of 40 years. Of the clinical ones of the medical care that requested inadequate tests, 51,3 percents were masculine, 79,4 percents were doctors, 53,4 percents were doctors of the apprentice and 8,2 percents were urólogos. The “doctors who were specialistic of the urología, man, orderers of the PSA tests and affiliated infrequent with the specific hospitals had levels perceivably more stops of the inadequate investigation of PSA. Compared with taking care of doctors, the nurses and the assistants of the doctor perceivably had inferior levels of the inadequate investigation,” the authors write. “The percentage of the inadequate investigation of PSA increased perceivably with the age of the masculine suppliers of the medical care,” they continues. “The cause of these the differences of sex and the age is not clear. It is possible that, as they age, the masculine suppliers of the medical care empathize more and more with his excessive preoccupations of the cancer of the prostate of older masculine patients. His “prostatemphathy” can then lead to one more a more aggressive investigation in these older masculine patients.” The patient changes of the education and the system-level, such as an automated system that it could alert when clinical they try to request an inadequate test of PSA, could help to reduce the level of the erroneous use of the investigation of PSA, the authors conclude.
