The majority of these patients, regardless of the initial diagnosis, considered the examination of the utmost importance and were determined to undergo it even if their personal approach to the test was characterized by different moods; only 3% of patients considered follow-up imaging no longer useful and reported their unwillingness to undergo clinical check-ups because of a deep state of anxiety. Although there are no studies in this direction, the damage caused to patients as a result of unnecessary testing should be emphasized; harm related to the loss of working days, transfer expenses, and especially stress related to the expectation and execution AG-881 cell line of the examination. The same stress may also be the indirect

Selleckchem EPZ015666 cause of the high value assigned by our oncological patients to the examination itself, thus SB525334 mouse triggering dangerous feedback. In our opinion this problem could be significantly reduced by creating new referral pathology centers where physicians are able to carry out correct work-up of the patients, share

clinical data and establish complete computerized centralization of requests with an updated list of all the diagnostic, as well as therapeutic procedures performed, along with their final outcome also in order to reduce unnecessary/harmful repetition of the same diagnostic tests. Furthermore, we hope for strict compliance with existing guidelines, or the creation of new, universally accepted guidelines that provide better clinical and legal justification of the timing and nature of diagnostic tests required for the follow-up of melanoma, and consequently reduce the problem of defensive medicine emerging in Italy’s medical-legal framework. Conclusion To conclude, it Vildagliptin is clear that about 30% of the US diagnostic examinations performed are unjustified according to the general guidelines currently in use. Therefore, they have not been requested according to strict clinical scientific parameters, but for other reasons, possibly medical-legal ones. Thus, there is need for

the adoption of new shared, widely accepted and easily applicable guidelines, also in light of other considerations related to health costs and medical-legal aspects. Given that said issues represent a thorny issue for other referral centers, we consider it absolutely necessary to update existing guidelines to make for easier use by specialists as well as General Practitioners. Electronic supplementary material Additional file 1: Form. (DOC 124 KB) References 1. Reed KB, Brewer JD, Lohse CM, Bringe K, Pruitt CN, Gibson LE: Increasing incidence of melanoma among young adults: an epidemiological study in Olmsted County, Minnesota. Mayo Clin Proc 2012,87(4):328–334.PubMedCrossRef 2. Cristofaro M, Busi Rizzi E, Schininà V, Chiappetta D, Angeletti C, Bibbolino C: Appropriateness: analysis of outpatient radiology requests. Radiol med 2012, 117:322–332.PubMedCrossRef 3. De Filippo M, Corsi A, Evaristi L, et al.