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Lead Time Bias
Lead time bias happens when survival time appears longer because diagnosis was done earlier (for instance, by screening), irrespective of whether the patient lived longer. Lead time is duration of time between detection of a disease (by screening or based on a new experimental criteria) and its usual clinical presentation and diagnosis (based on traditional criteria). For instance, it is the time between early detection by screening and the time in which diagnosis would have been made clinically (without screening). It is an important factor when evaluating the effectiveness of a specific test. Relationship between screening and survival The goal of screening is earlier detection - to diagnose a disease earlier than it would be without screening. Therefore, if screening works, it needs to advance in time the moment of diagnosis. In other words, screening needs to introduce a lead time. However, the lead time itself biases survival statistics: people with disease detected by scr ...
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Lead Time Bias
Lead time bias happens when survival time appears longer because diagnosis was done earlier (for instance, by screening), irrespective of whether the patient lived longer. Lead time is duration of time between detection of a disease (by screening or based on a new experimental criteria) and its usual clinical presentation and diagnosis (based on traditional criteria). For instance, it is the time between early detection by screening and the time in which diagnosis would have been made clinically (without screening). It is an important factor when evaluating the effectiveness of a specific test. Relationship between screening and survival The goal of screening is earlier detection - to diagnose a disease earlier than it would be without screening. Therefore, if screening works, it needs to advance in time the moment of diagnosis. In other words, screening needs to introduce a lead time. However, the lead time itself biases survival statistics: people with disease detected by scr ...
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Five-year Survival Rate
The five-year survival rate is a type of survival rate for estimating the prognosis of a particular disease, normally calculated from the point of diagnosis. Lead time bias from earlier diagnosis can affect interpretation of the five-year survival rate. There are absolute and relative survival rates, but the latter are more useful and commonly used. Relative and absolute rates Five-year relative survival rates are more commonly cited in cancer statistics. Five-year absolute survival rates may sometimes also be cited. * Five-year ''absolute'' survival rates describe the percentage of patients alive five years after the disease is diagnosed. * Five-year ''relative'' survival rates describe the percentage of patients with a disease alive five years after the disease is diagnosed, divided by the percentage of the general population of corresponding sex and age alive after five years. Typically, cancer five-year relative survival rates are well below 100%, reflecting excess mortality ...
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Huntington's Disease
Huntington's disease (HD), also known as Huntington's chorea, is a neurodegenerative disease that is mostly inherited. The earliest symptoms are often subtle problems with mood or mental abilities. A general lack of coordination and an unsteady gait often follow. It is also a basal ganglia disease causing a hyperkinetic movement disorder known as chorea. As the disease advances, uncoordinated, involuntary body movements of chorea become more apparent. Physical abilities gradually worsen until coordinated movement becomes difficult and the person is unable to talk. Mental abilities generally decline into dementia. The specific symptoms vary somewhat between people. Symptoms usually begin between 30 and 50 years of age but can start at any age. The disease may develop earlier in each successive generation. About eight percent of cases start before the age of 20 years, and are known as ''juvenile HD'', which typically present with the slow movement symptoms of Parkinson's d ...
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Length Time Bias
Length time bias (or length bias) is an overestimation of survival duration due to the relative excess of cases detected that are asymptomatically slowly progressing, while fast progressing cases are detected after giving symptoms. Length time bias is often discussed in the context of the benefits of cancer screening, and it can lead to the perception that screening leads to better outcomes when in reality it has no effect. Fast-growing tumors generally have a shorter asymptomatic In medicine, any disease is classified asymptomatic if a patient tests as carrier for a disease or infection but experiences no symptoms. Whenever a medical condition fails to show noticeable symptoms after a diagnosis it might be considered asy ... phase than slower-growing tumors. Thus, there is a shorter period of time during which the cancer is present in the body (and so might be detected by screening) but not yet large enough to cause symptoms, that would cause the patient to seek medical care ...
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Epidemiology
Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population. It is a cornerstone of public health, and shapes policy decisions and evidence-based practice by identifying risk factors for disease and targets for preventive healthcare. Epidemiologists help with study design, collection, and statistical analysis of data, amend interpretation and dissemination of results (including peer review and occasional systematic review). Epidemiology has helped develop methodology used in clinical research, public health studies, and, to a lesser extent, basic research in the biological sciences. Major areas of epidemiological study include disease causation, transmission, outbreak investigation, disease surveillance, environmental epidemiology, forensic epidemiology, occupational epidemiology, screening, biomonitoring, and comparisons of treatment effects such as in clinical trials. ...
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Medical Statistics
Medical statistics deals with applications of statistics to medicine and the health sciences, including epidemiology, public health, forensic medicine, and clinical research. Medical statistics has been a recognized branch of statistics in the United Kingdom for more than 40 years but the term has not come into general use in North America, where the wider term 'biostatistics' is more commonly used.Dodge, Y. (2003) ''The Oxford Dictionary of Statistical Terms'', OUP. However, "biostatistics" more commonly connotes all applications of statistics to biology. Medical statistics is a subdiscipline of statistics. "It is the science of summarizing, collecting, presenting and interpreting data in medical practice, and using them to estimate the magnitude of associations and test hypotheses. It has a central role in medical investigations. It not only provides a way of organizing information on a wider and more formal basis than relying on the exchange of anecdotes and personal experien ...
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