Background: Investigating changes in prediagnostic healthcare utilisation can help identify how much earlier conditions could be diagnosed. Such 'diagnostic windows' are established for cancer but remain relatively unexplored for non-neoplastic conditions.
Aim: To extract evidence on the presence and length of diagnostic windows for non-neoplastic conditions.
Design And Setting: A systematic review of studies of prediagnostic healthcare utilisation was carried out.
Method: A search strategy was developed to identify relevant studies from PubMed and Connected Papers. Data were extracted on prediagnostic healthcare use, and evidence of diagnostic window presence and length was assessed.
Results: Of 4340 studies screened, 27 were included, covering 17 non-neoplastic conditions, including both chronic (for example, Parkinson's disease) and acute conditions (for example, stroke). Prediagnostic healthcare events included primary care encounters and presentations with relevant symptoms. For 10 conditions, sufficient evidence to determine diagnostic window presence and length was available, ranging from 28 days (herpes simplex encephalitis) to 9 years (ulcerative colitis). For the remaining conditions, diagnostic windows were likely to be present, but insufficient study duration was often a barrier to robustly determining their length, meaning that diagnostic window length may exceed 10 years for coeliac disease, for example.
Conclusion: Evidence of changing healthcare use before diagnosis exists for many non-neoplastic conditions, establishing that early diagnosis is possible, in principle. In particular, some conditions may be detectable many years earlier than they are currently diagnosed. Further research is required to accurately estimate diagnostic windows and to determine how much earlier diagnosis may be possible, and how this might be achieved.
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http://dx.doi.org/10.3399/BJGP.2023.0044 | DOI Listing |
Mov Disord
January 2025
Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Background: Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy of ventral intermediate (Vim) nucleus is useful to treat drug-resistant tremor-dominant Parkinson's disease (TdPD), but tremor relapse may occur. Predictors of relapse have been poorly investigated so far.
Objective: The aim of this study is to evaluate the role of clinico-demographic, procedural, and neuroradiological variables in determining clinical response, relapse, and adverse events (AEs) in TdPD after MRgFUS Vim-thalamotomy.
Int J Gynaecol Obstet
January 2025
Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Pulmonary sequestration is a rare pulmonary malformation, typically characterized by asymptomatic presentation or recurrent pulmonary infections, with chest pain and hemothorax being exceedingly rare occurrences. The rupture and hemorrhage of maternal pulmonary sequestration during pregnancy pose a life-threatening condition that is challenging to diagnose. We present a case of a 37-year-old pregnant woman in her third trimester who presented with acute progressive hemothorax, a complication arising from maternal pulmonary sequestration.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Pediatrics, Division of Infectious Diseases, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Neonatal health is dependent on early risk stratification, diagnosis, and timely management of potentially devastating conditions, particularly in the setting of prematurity. Many of these conditions are poorly predicted in real-time by clinical data and current diagnostics. Umbilical cord blood may represent a novel source of molecular signatures that provides a window into the state of the fetus at birth.
View Article and Find Full Text PDFNat Commun
January 2025
The Faculty of Data and Decisions Sciences, Technion - Israel Institute of Technology, Haifa, Israel.
Large Language Models (LLMs) have shown success in predicting neural signals associated with narrative processing, but their approach to integrating context over large timescales differs fundamentally from that of the human brain. In this study, we show how the brain, unlike LLMs that process large text windows in parallel, integrates short-term and long-term contextual information through an incremental mechanism. Using fMRI data from 219 participants listening to spoken narratives, we first demonstrate that LLMs predict brain activity effectively only when using short contextual windows of up to a few dozen words.
View Article and Find Full Text PDFEpilepsy Behav
January 2025
Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address:
Purpose: Concurrent electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) have been used to assist in the presurgical localization of seizure foci in people with epilepsy. Our study aimed to examine the clinical feasibility of an optimized concurrent EEG-fMRI protocol.
Methods: The optimized protocol employed a fast-fMRI sequence (sampling rate = 10 Hz) with a spare arrangement, which allowed a time window of 1.
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