Cardio-metabolic risk modeling and assessment through sensor-based measurements.

Objective: Cardio-metabolic risk assessment in the general population is of paramount importance to reduce diseases burdened by high morbility and mortality. The present paper defines a strategy for out-of-hospital cardio-metabolic risk assessment, based on data acquired from contact-less sensors.

Methods: We employ Structural Equation Modeling to identify latent clinical variables of cardio-metabolic risk, related to anthropometric, glycolipidic and vascular function factors.

The professional quality criteria of Italian breast screening radiologists: results from a national survey comparing the programmes started in 2000-2012 versus the ones started in 1990-1999.

Introduction: In Italy, due to increasing healthcare budget and staff shortages, the recently created regional mammography screening programmes were established under worse radiology practice quality criteria than the previously created programmes.

Methods: Using available data from a national questionnaire survey conducted at the end of 2013 and involving 222 responder radiologists, we compared the main professional quality standards of radiologists working in the screening programmes established during the period 2000-2012 with those working in the screening programmes created from 1990 to 1999.

Results: The former reported more years of clinical experience in breast imaging and a greater clinical mammogram reading volume than the latter.

Factors associated with breast screening radiologists' annual mammogram reading volume in Italy.

Purpose: Screening mammogram reading volume (SMRV) and total (screening and clinical) mammogram reading volume (TMRV) per year are strongly associated with the radiologist's diagnostic performance in breast cancer screening. The current article reports the prevalence and correlates of a SMRV and a TMRV ≥5000 among Italian breast screening radiologists.

Materials And Methods: A questionnaire survey was carried out in 2013-2014 by the Italian Group for Mammography Screening (GISMa).

Problems, solutions, and perspectives in the evaluation of interval cancers in Italian mammography screening programmes: a position paper from the Italian group for mammography screening (GISMa).

In this position paper, a self-convened team of experts from the Italian Group for Mammography Screening (Gruppo italiano screening mammografico, GISMa) pointed out the problems that increasingly hamper the feasibility and validity of the estimate of the proportional incidence of interval breast cancer (IBC) in Italy, suggested potential solutions and an agenda for research, and proposed that the question of the sensitivity of mammography be viewed in a larger perspective, with a greater attention to radiological review activities and breast radiology quality assurance programmes. The main problems are as follows: the coverage of cancer registration is incomplete; the robustness of using the pre-screening incidence rates as underlying rates decreases with time since the start of screening; the intermediate mammograms performed for early detection purposes may cause an overrepresentation of IBCs; the classification of many borderline screening histories is prone to subjectivity; and, finally, the composition of cohorts of women with negative screening results is uncertain, because several mammography reports are neither clearly negative nor clearly positive, and because of the limitations and instability of the electronic mammography records. Several possibilities can be considered to cope with these issues: standard methods for using the hospital discharge records in the identification of IBCs should be established; for the calculation of regional estimates of the underlying incidence, a suitable mathematical model should be identified; the definition of IBC according to the 2008 GISMa guidelines needs to be updated, especially with respect to in situ cancers and to invasive cancers with borderline screening histories; a closer adherence to standard screening protocols, with a simplified patient management, would make it easier to objectively identify IBCs; alternative methods for estimating the sensitivity of mammography should be taken into consideration; and, finally, analysis could be restricted to the absolute incidence rate of IBC, which would make comparison of the risk between neighbouring populations possible.

Breast cancer screening in Italy: evaluating key performance indicators for time trends and activity volumes.

Together with the National centre for screening monitoring (ONS), GISMa supports annual collection of data on national breast screening activities. Aggregated data on implementation and performance are gathered through a standardized form to calculate process and impact indicators. Analyzed data belong to 153 local programmes in the period 2006-2011 (2006-2012 for participation rate only).

Mammographic breast cancer screening in Italy: 2011-2012 survey.

This report is an update of a number of papers that have been published by the ONS (Osservatorio nazionale screening, National centre for screening monitoring) since 2002. Data for the survey come from several programmes that may have changed over time, and may have different settings of organization and management. During 2011-2012, a slight increase in actual extension was recorded compared to the previous years.

Cervical cancer screening in immigrant women in Italy: a survey on participation, cytology and histology results.

Cervical cancer screening programmes in Italy actively invite all 25-64-year-old resident women for the Pap test every 3 years irrespective of their citizenship. Immigrant women come from countries where screening is absent or poorly implemented and the prevalence of human papillomavirus is often high. These women therefore have significant risk factors for cervical cancer.

A wize mirror for lifestyle improvement.

This paper discusses the problem of fostering lifestyle changes towards healthier habits via tailored user guidance. We present a novel multisensory device, the Wize Mirror, which will be able to detect semeiotic face signs related to cardio-metabolic risk, and encourage users to reduce their risk by improving their lifestyle. Offering a proper user guidance requires solving three main issues: user profiling, definition of a wellness index based on biophysical data, and personalized guidance by means of coaching and supportive messages.

A comparison of different strategies used to invite subjects with a positive faecal occult blood test to a colonoscopy assessment. A randomised controlled trial in population-based screening programmes.

Objective: The purpose of this parallel randomised controlled trial was to compare compliance with different modalities used to invite patients with a positive immunochemical faecal occult blood test (FIT+) for a total colonoscopy (TC).

Method: FIT+ patients from nine Italian colorectal cancer screening programmes were randomised to be invited for a TC initially by mail or by phone and, for non-compliers, to be recalled by mail, for counselling with a general practitioner, or to meet with a specialist screening practitioner (nurse or healthcare assistant).

Results: In all, 3777 patients were randomised to different invitation strategies.

[Time trends of process and impact indicators in Italian breast screening programmes (2000-2010)].

Since its establishment in 1990, one of the main tasks of the Italian group for breast cancer screening (GISMa) is the systematic data collection on the activity of the organised breast cancer screening programmes implemented in Italy. Data are collected in an aggregated way and gathered through a standardised form to calculate process and impact parameters. Data analysis from 2000-2010 shows that crude attendance rate reached the acceptable 50% standard, presenting a higher level of participation in Northern and Central Italy compared to Southern Italy/Islands, where attendance rates are still inadequate and do not reach the acceptable standard.

[Mammography breast cancer screening in Italy: 2010 survey].

This report is an update of similar previous papers that have been published by the ONS (Osservatorio nazionale screening, National Centre for Screening Monitoring) since 2002. Data for the survey come from several different programmes that may have changed over time, and may have different settings of organisation and management. During 2010, the first slight decrease in theoretical extension was recorded.

Time trends of process and impact indicators in Italian breast screening programmes (1999-2009).

Since its establishment in 1990, one of the main tasks of the Italian group for mammography screening (GISMa) is the systematic data collection on the activity of the organised mammography screening programmes implemented in Italy. Data are collected in an aggregated way and gathered through a standardised form to calculate process and impact parameters. Data analysis from 1999-2009 shows that crude attendance rate reached the acceptable 50% standard, presenting a higher level of participation in northern and central Italy compared to southern Italy/Islands, where attendance rates are still inadequate and do not reach the acceptable standard.

Mammography screening in Italy: 2009 survey.

This report is an update of similar previous papers that have been published by the ONS (Osservatorio nazionale screening, National Centre for Screening Monitoring) since 2002. Data for the survey come from several different programmes that may have changed over time, and may have different settings of organisation and management. During 2009, an increase in theoretical extension was recorded; however, this was not followed by an increase in actual extension, which remained stable.

Time trends of process and impact indicators in Italian breast screening programmes: 1998-2008.

Since its establishment in 1990, one of the main tasks of the Italian Group for Mammography Screening (GISMa) is the systematic data collection on the activity of the organised mammography screening programmes implemented in Italy. Data are collected in an aggregated way and gathered through a standardised form to calculate process and impact parameters. Data analysis referring to the period 1998-2008 shows that crude attendance rate reached the acceptable 50% standard, presenting a higher level of participation in Northern and Central Italy compared to Southern Italy/Islands, where attendance rates are still inadequate and do not reach the acceptable standard.

Mammography screening in Italy: 2008 survey.

This report is an update of similar previous papers that have been published by the ONS (Osservatorio Nazionale Screening, National Centre for Screening Monitoring) since 2002. Data for the survey come from several different programmes that may have changed over time, and may have different settings of organisation and management. During 2007, a further increase in screening activity was recorded, with the inclusion of all Northern and Central Italian Regions, and a further development in the Southern Regions and Islands, so today all Italian Regions have implemented screening programmes.

Time trends of process and impact indicators in Italian breast screening programmes: 1998-2007.

Since its establishment in 1990, one of the main tasks of the Italian Group for Mammography Screening (GISMa) has been that of collecting, as systematically and thoroughly as possible, data on the activity of the Italian mammography screening programmes. Data are collected in an aggregated way and gathered through a standardised form to calculate process and impact parameters. Analysis of data referring to the period 1998-2007 shows that crude attendance rate reached the acceptable 50% standard, presenting a higher level of participation in Northern and Central Italy compared to Southern Italy/Islands, where attendance rates are still inadequate and do not reach the acceptable standard.

Mammography screening in Italy: 2007 survey.

This report is an update of similar previous papers that have been published by the ONS (Osservatorio Nazionale Screening, National Centre for Screening Monitoring) since 2002. Data for the survey come from several different programmes that may have changed over time, and may have different settings of organisation and management. During 2007, a further increase in screening activity was recorded, with the inclusion of all Northern and Central Italian Regions, and a further development in the Southern Regions and Islands.

Physical activity and mammographic breast density in a Mediterranean population: the EPIC Florence longitudinal study.

A protective effect of physical activity (PA) on breast cancer (BC) risk has been suggested. Few studies have examined the influence of PA on mammographic breast density (MBD), a strong risk factor for BC. In a prospective study in Florence, Italy, we identified 2,000 healthy women with a mammogram taken 5 years after enrollment.

Time trends of process and impact indicators in Italian breast screening programmes--1996-2005.

Since its establishment in 1990, one of the main tasks of the Italian Group for Mammography Screening (GISMa) has been that of collecting, as systematically and thoroughly as possible, data on the activity of the various mammography screening programmes implemented in Italy. Data are collected in an aggregated way and gathered through a standardised form to calculate process and impact parameters. Analysis of data collected in the period 1996-2006 shows that the number of Italian women involved in mammography screening has constantly increased over time.

Mammography screening in Italy: 2005 survey and 2006 preliminary data.

Mammography screening programmes in Italy have been implemented since the early 90's. Over the last ten years, national and international institutions have strongly supported screening programme implementation with several laws. Since 2004, the Italian Ministry of Health, together with the Commission of Regions and Self-governing Provinces Health Officials, has officially entrusted the ONS (Osservatorio Nazionale Screening, National Centre for Screening Monitoring) with monitoring and promoting nationwide screening programmes.

[Interval cancers as indicators of performance in screening programmes].

GISMa analyses the interval cancer (IS) topic providing guidelines and reference standards in addition to CE recommendations. IC identification is based on Cancer Registries (CR), if existing, or on hospital discharge records, in alternative. The optimal measure of IC frequency (inversely correlated with sensitivity) is the IC proportional incidence (observed IC/carcinomas expected in absence of screening).

Time trends of process and impact indicators in Italian mammography screening programmes--1996-2004.

Since 1990, the Italian Group for Mammography Screening (GISMa) has been promoting the development of new organised programmes and performing a yearly systematic survey of data activity. The screening extension has increased over time, reaching an overall 76.4% of coverage in 2005.

Mammography screening in Italy: 2004 survey and 2005 preliminary data.

In 2004 regions were required to provide the ONS (Osservatorio Nazionale Screening, National Centre for Screening Monitoring) with data on screening activity. Previously, GISMa (Gruppo Italiano Screening Mammografico) had for several years carried out a yearly survey to collect process indicators of mammography screening and compare them, using standard values agreed on at a national and international level. In 2006, an updated version of the operative report of process indicators was published by GISMa and ONS.

Time trends of some indicators of mammography screening programmes in Italy, 1996-2003.

Since 1992, the Italian Group for Mammography Screening (GISMa) has been performing a yearly systematic survey of ongoing activities. The screening extension increased from 1996, reaching an overall 68.7% coverage in 2004.

Mammography screening in Italy: 2003-2004 survey.

GISMa performs a yearly survey to collect process indicators of mammography screening and compare them, using standard values agreed on a national and international basis. This survey is highly representative of the Italian situation, providing summary data stratified by region and by age group. Data come from several different programmes that may have changed over time, and may have different model of organisation and management.