Notice bibliographique
Résumé
To the Editor: Overdiagnosis challenges the assessment of the effect of environmental factors on the incidence of thyroid cancer.1 In fact, to identify the determinants of the trends of this cancer, the poster child of a “scrutiny-dependent” cancer,2 we need to move from classical epidemiology, which aims to understand patterns and causes of diseases, toward an epidemiology of diagnoses that aims to understand patterns and causes of diagnoses. Overdiagnosis is the diagnosis of an abnormality that is not associated with a substantial health hazard and of which people experience no benefit from awareness; it is not a misdiagnosis and not a false-positive result.3 Screening, incidental findings, increasingly sensitive screening and diagnostic tests, and widening diagnostic criteria to define a disease are causes of overdiagnosis.3 There is high-quality observational evidence from many countries that thyroid cancer overdiagnosis has a major impact on the incidence of this cancer.1,4 But this does not mean that no other factors have an effect on thyroid cancer incidence. As van Gerwen et al.1 have noted, several environmental factors could be involved in thyroid cancer trends. However, the effect of overdiagnosis on incidence can be so strong that it makes it difficult to identify environmental risk factors and quantify their contribution. Even in Japan following the Fukushima nuclear power plant accident, estimation of the effect of radiation—on top of the contribution of screening activities—remains a challenge.4,5 Hence, shortly after the accident in 2011, a screening program was implemented and a large number of thyroid cancers were found, including in children, raising major fear. Most cases were, however, probably overdiagnosed and not caused by the radiation because (1) the time lag between the accident and the detection of these cases was very short and (2) there was no correlation between the increase in incidence and regional levels of radiation exposure.5 The problem is that the absolute effect size of any environmental factors is most often small compared with the impact of overdiagnosis of such cancer. More broadly, thyroid cancer and other scrutiny dependent diseases (e.g., prostate cancer, melanoma, pulmonary embolism, or chlamydia infection) forces us to move from classical epidemiology toward an epidemiology of diagnosis. It means that the detection, screening, and history of diagnosis have to be documented in detail, in a population-based setting, for insightful analysis of trends.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».