Bmc Med
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Based on a large, representative unscreened cohort from Malmö, Sweden, we have recently reported that a single prostate-specific antigen (PSA) measurement at or before age 50 is a strong predictor of prostate cancer occurring up to 25 years subsequently. We aimed to determine whether this association holds for advanced cancers, defined as clinical stage T3 or higher, or skeletal metastasis at the time of the cancer diagnosis. ⋯ A single PSA test taken at or before age 50 is a very strong predictor of advanced prostate cancer diagnosed up to 25 years later. This suggests the possibility of using an early PSA test to risk-stratify patients so that men at highest risk are the focus of the most intensive screening efforts.
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Comparative Study
Graduates of different UK medical schools show substantial differences in performance on MRCP(UK) Part 1, Part 2 and PACES examinations.
The UK General Medical Council has emphasized the lack of evidence on whether graduates from different UK medical schools perform differently in their clinical careers. Here we assess the performance of UK graduates who have taken MRCP(UK) Part 1 and Part 2, which are multiple-choice assessments, and PACES, an assessment using real and simulated patients of clinical examination skills and communication skills, and we explore the reasons for the differences between medical schools. ⋯ Candidates from different UK medical schools perform differently in all three parts of the MRCP(UK) examination, with the ordering consistent across the parts of the exam and with the differences in Part 1 performance being consistent from 1989 to 2005. Although pre-admission qualifications explained some of the medical school variance, the remaining differences do not seem to result from career preference or other selection biases, and are presumed to result from unmeasured differences in ability at entry to the medical school or to differences between medical schools in teaching focus, content and approaches. Exploration of causal mechanisms would be enhanced by results from a national medical qualifying examination.