ABSTRACT
OBJECTIVES: The main aim of the lung cancer screening (LCS) feasibility study was to investigate the plausibility of and bottlenecks to systematic enrolment in family physician practices by evaluating all their patients. METHODS: In 3 family physician practices, for each individual born in 1947-1966 (target age group 55-74 years), information on ever smoking was gathered by a family physician/nurse. All current and ex-smokers were invited to an 'LCS visit'. In parallel, 2 inclusion criteria were used: (1) current smoker (≥20 pack-years) or ex-smoker (quit <15 years ago and smoking history ≥20 pack-years) and (2) PLCOm2012noRace risk score >1.5. All individuals with elevated lung cancer risk were assigned low-dose computed tomography. RESULTS: Among the total 7035 individuals in the 3 family physician practices, the LCS target age group comprised 1208 individuals, including 649 (46.3-57.1%) males and 559 (42.9-53.7%) females. Of the 1208 applicable age group individuals, 395 (all current or ex-smokers) were invited to the 'LCS visit'. According to either 1 or both the LCS inclusion criteria, 206 individuals were referred to low-dose computed tomography, and 201 (97.6% of those referred) ended up taking it. The estimated participation rate in LCS, based on data from our feasibility study, would have been 87.4%. CONCLUSIONS: In LCS, systematic enrolment of individuals by family physicians results in high uptake, and thus, effectiveness of the LCS in the setting of a well-functioning family physician system like in Estonia. Also, the feasibility study provided excellent input to the currently ongoing regional LCS pilot study in Estonia.
ABSTRACT
There is a lack of robust prevalence estimates of atopic dermatitis (AD) globally and trends over time due to wide variation of populations and age groups studied, different study methodologies and case definitions used. We sought to characterize 12-month AD prevalence across the life span and change over time in resource-rich countries focusing on population-based studies and using a standardized AD case definition. This systematic review was conducted according to PRISMA guidelines. Medline (Ovid), Embase, WOS core collection, Cinahl, and Popline were searched for studies published since inception through August 15, 2016. Studies were synthesized using random effects meta-analysis. Sources of heterogeneity were investigated using subgroup analyses and meta-regression. From 12,530 records identified, 45 studies met the inclusion criteria. Meta-analysis with random effects revealed the 12-month period prevalence of 9.2% (95% confidence interval 8.4-10.1%). The prevalence was significantly higher among 0-5-year-old children (16.2%; 95% confidence interval 14.2-18.7%) than in older age groups. Studies using a random sampling strategy yielded lower prevalence estimates than studies relying on other sampling methods. There was no clear time trend in AD prevalence over the period of 1992-2013.
