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  1. Article: Le nuove raccomandazioni sullo screening mammografico per le donne con più di 70 anni.

    Giorgi Rossi, Paolo

    Epidemiologia e prevenzione

    2023  Volume 47, Issue 3, Page(s) 192–197

    Abstract: The new recommendations of the European Council (December 2022) indicate to the Member States to implement mammography screening programs for women aged 45 to 74 and make explicit reference to the European guidelines produced by the ECIBC (European ... ...

    Title translation New recommendations on mammography screening for women over 70 years.
    Abstract The new recommendations of the European Council (December 2022) indicate to the Member States to implement mammography screening programs for women aged 45 to 74 and make explicit reference to the European guidelines produced by the ECIBC (European Commission Initiative on Breast Cancer) for operational indications. For women aged 70-74, the ECIBC suggests a three-year interval, rather than two years, and the process of adaptation and adoption of the guidelines in Italy has taken this recommendation as it is. Previous indications for Italian screening programs proposed a two-year interval for all women over 50 years of age. The intervention analyzes the rationale and interpretation of the evidence that led to the formulation of the different recommendations. It discusses whether the new recommendations fit into the perspective of risk-stratified screening that is under evaluation by several studies. it analyzes some of the critical issues of the methodology for developing recommendations in defining the characteristics of complex interventions, in particular the difficulties that the formulation of dichotomous questions finds in answering questions such as what is the best age to stop screening and what is the best interval at any age, which require an analysis of a continuous variable as age or interval duration. Finally, the opportunities and limitations in producing evidence regarding the best interval to adopt in mammography screening are discussed.
    MeSH term(s) Female ; Humans ; Middle Aged ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/epidemiology ; Early Detection of Cancer ; Italy/epidemiology ; Mammography/trends ; Mass Screening/methods
    Language Italian
    Publishing date 2023-06-19
    Publishing country Italy
    Document type English Abstract ; Journal Article
    ZDB-ID 1038112-0
    ISSN 1120-9763
    ISSN 1120-9763
    DOI 10.19191/EP23.3.A632.036
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  2. Article ; Online: Il coinvolgimento dei professionisti e degli utenti può aiutarci a disegnare interventi di prevenzione più efficaci?

    Giorgi Rossi, Paolo

    Recenti progressi in medicina

    2023  Volume 114, Issue 6, Page(s) 375–376

    Abstract: The involvement of users and stakeholders in the co-creation of services for citizens presents some critical issues when applied to prevention. In healthcare, the perimeter of effective and appropriate interventions is defined by guidelines and users ... ...

    Title translation Can the involvement of professionals and users help us design more effective prevention interventions?
    Abstract The involvement of users and stakeholders in the co-creation of services for citizens presents some critical issues when applied to prevention. In healthcare, the perimeter of effective and appropriate interventions is defined by guidelines and users often lack the tools to discuss its boundaries. It is necessary that the selection of possible interventions does not appear arbitrary, agreeing from the outset on which criteria and sources will be adopted. Furthermore, in prevention, what is identified as a need by the health service is not always perceived as such by potential users. The different assessment of needs leads to perceiving possible interventions as undue interferences in lifestyle choices.
    MeSH term(s) Humans ; Mental Health Services ; Life Style
    Language Italian
    Publishing date 2023-05-25
    Publishing country Italy
    Document type English Abstract ; Journal Article
    ZDB-ID 138266-4
    ISSN 2038-1840 ; 0034-1193
    ISSN (online) 2038-1840
    ISSN 0034-1193
    DOI 10.1701/4042.40233
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  3. Article ; Online: Excluding specificity from research and development priorities is delaying the AI adoption in breast cancer screening.

    Giorgi Rossi, Paolo

    European radiology

    2023  Volume 33, Issue 7, Page(s) 4597–4599

    MeSH term(s) Humans ; Female ; Breast Neoplasms/diagnostic imaging ; Artificial Intelligence ; Retrospective Studies ; Early Detection of Cancer ; Mammography ; Research
    Language English
    Publishing date 2023-05-23
    Publishing country Germany
    Document type Editorial ; Comment
    ZDB-ID 1085366-2
    ISSN 1432-1084 ; 0938-7994 ; 1613-3749
    ISSN (online) 1432-1084
    ISSN 0938-7994 ; 1613-3749
    DOI 10.1007/s00330-023-09733-7
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  4. Article ; Online: What a woman needs to know about overdiagnosis to decide about breast cancer screening.

    Giorgi Rossi, Paolo

    European journal of cancer (Oxford, England : 1990)

    2022  Volume 173, Page(s) 327–328

    MeSH term(s) Breast Neoplasms/diagnosis ; Breast Neoplasms/prevention & control ; Early Detection of Cancer ; Female ; Humans ; Mammography ; Mass Screening ; Medical Overuse ; Overdiagnosis
    Language English
    Publishing date 2022-08-05
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 82061-1
    ISSN 1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
    ISSN (online) 1879-0852
    ISSN 0277-5379 ; 0959-8049 ; 0964-1947
    DOI 10.1016/j.ejca.2022.06.056
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  5. Article: Why so much uncertainty about adjuvant HPV vaccines after local treatment? Can the discrepancy between the positive statistical results and the scientific community doubts be solved?

    Giorgi-Rossi, Paolo / Tornesello, Maria Lina / Buonaguro, Franco Maria

    Infectious agents and cancer

    2024  Volume 19, Issue 1, Page(s) 11

    Language English
    Publishing date 2024-04-04
    Publishing country England
    Document type Editorial
    ZDB-ID 2251117-9
    ISSN 1750-9378
    ISSN 1750-9378
    DOI 10.1186/s13027-024-00572-9
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  6. Article ; Online: The effect of diabetes on COVID-19 incidence and mortality: Differences between highly-developed-country and high-migratory-pressure-country populations.

    Ottone, Marta / Bartolini, Letizia / Bonvicini, Laura / Giorgi Rossi, Paolo

    Frontiers in public health

    2023  Volume 11, Page(s) 969143

    Abstract: The objective of this study was to compare the effect of diabetes and pathologies potentially related to diabetes on the risk of infection and death from COVID-19 among people from Highly-Developed-Country (HDC), including Italians, and immigrants from ... ...

    Abstract The objective of this study was to compare the effect of diabetes and pathologies potentially related to diabetes on the risk of infection and death from COVID-19 among people from Highly-Developed-Country (HDC), including Italians, and immigrants from the High-Migratory-Pressure-Countries (HMPC). Among the population with diabetes, whose prevalence is known to be higher among immigrants, we compared the effect of body mass index among HDC and HMPC populations. A population-based cohort study was conducted, using population registries and routinely collected surveillance data. The population was stratified into HDC and HMPC, according to the place of birth; moreover, a focus was set on the South Asiatic population. Analyses restricted to the population with type-2 diabetes were performed. We reported incidence (IRR) and mortality rate ratios (MRR) and hazard ratios (HR) with 95% confidence interval (CI) to estimate the effect of diabetes on SARS-CoV-2 infection and COVID-19 mortality. Overall, IRR of infection and MRR from COVID-19 comparing HMPC with HDC group were 0.84 (95% CI 0.82-0.87) and 0.67 (95% CI 0.46-0.99), respectively. The effect of diabetes on the risk of infection and death from COVID-19 was slightly higher in the HMPC population than in the HDC population (HRs for infection: 1.37 95% CI 1.22-1.53 vs. 1.20 95% CI 1.14-1.25; HRs for mortality: 3.96 95% CI 1.82-8.60 vs. 1.71 95% CI 1.50-1.95, respectively). No substantial difference in the strength of the association was observed between obesity or other comorbidities and SARS-CoV-2 infection. Similarly for COVID-19 mortality, HRs for obesity (HRs: 18.92 95% CI 4.48-79.87 vs. 3.91 95% CI 2.69-5.69) were larger in HMPC than in the HDC population, but differences could be due to chance. Among the population with diabetes, the HMPC group showed similar incidence (IRR: 0.99 95% CI: 0.88-1.12) and mortality (MRR: 0.89 95% CI: 0.49-1.61) to that of HDC individuals. The effect of obesity on incidence was similar in both HDC and HMPC populations (HRs: 1.73 95% CI 1.41-2.11 among HDC vs. 1.41 95% CI 0.63-3.17 among HMPC), although the estimates were very imprecise. Despite a higher prevalence of diabetes and a stronger effect of diabetes on COVID-19 mortality in HMPC than in the HDC population, our cohort did not show an overall excess risk of COVID-19 mortality in immigrants.
    MeSH term(s) Humans ; COVID-19/epidemiology ; Incidence ; Cohort Studies ; SARS-CoV-2 ; Obesity/epidemiology ; Diabetes Mellitus/epidemiology
    Language English
    Publishing date 2023-03-08
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2023.969143
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  7. Article ; Online: La privacy e l’epidemiologia: troviamo una soluzione condivisa.

    Bisceglia, Lucia / Caranci, Nicola / Giorgi Rossi, Paolo / Zengarini, Nicolás

    Recenti progressi in medicina

    2023  Volume 114, Issue 6, Page(s) 332–336

    Abstract: During the pandemic period, Italian epidemiologists managed to monitor the situation despite fragmented and often low-quality data flows, comparing themselves to other countries (such as England and Israel) that were able to provide valuable indications ... ...

    Title translation Privacy and epidemiology: let's find a shared solution.
    Abstract During the pandemic period, Italian epidemiologists managed to monitor the situation despite fragmented and often low-quality data flows, comparing themselves to other countries (such as England and Israel) that were able to provide valuable indications in very short times thanks to the availability of a large amount of interconnected data at the national level. In the same months, the Italian Data Protection Authority launched several investigations that triggered an immediate stiffening of the mechanisms for accessing data by epidemiological structures at both regional and company levels, leading to a significant limitation in the conduct of epidemiological investigations, and in some cases the complete suspension of important projects. The interpretation of the General data protection regulation (Gdpr) was found to be subjective and heterogeneous among different institutions. The path to legitimizing data processing appears obscure and subject to the sensitivity of the different actors involved in the process within companies and regions. Apparently, only economic reporting is unanimously considered the primary and legitimate use of data. The work of Italian epidemiologists has been called into question to the point of making it practically impossible to carry out their institutional duties, even though they are an integral part of the National health service's (Nhs) function to promote and ensure health and well-being for the population. Today, it is necessary to immediately initiate a path to identify shared solutions among the various actors at both the central and local levels, which allow epidemiological structures and professionals to carry out their tasks with serenity, while ensuring data protection. The obstacles to conducting epidemiological studies are not a problem of individual operators or individual epidemiology structures, but a block to the production of knowledge and, ultimately, to the processes of improving the Nhs.
    MeSH term(s) Humans ; Privacy ; State Medicine ; Italy/epidemiology
    Language Italian
    Publishing date 2023-05-25
    Publishing country Italy
    Document type English Abstract ; Journal Article
    ZDB-ID 138266-4
    ISSN 2038-1840 ; 0034-1193
    ISSN (online) 2038-1840
    ISSN 0034-1193
    DOI 10.1701/4042.40224
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  8. Article: Perché funziona? Per costruire raccomandazioni migliori gli studi dovrebbero aiutarci a capire perché un intervento funziona, non solo se è migliore del controllo.

    Giorgi Rossi, Paolo / Paci, Eugenio

    Epidemiologia e prevenzione

    2020  Volume 44, Issue 4, Page(s) 205–209

    Title translation Why does it work? To build better clinical recommendations, studies should help us to understand why an intervention works and not only if it works better than the control.
    MeSH term(s) Controlled Clinical Trials as Topic ; Humans ; Italy/epidemiology ; Research Design/standards
    Language Italian
    Publishing date 2020-05-22
    Publishing country Italy
    Document type News
    ZDB-ID 1038112-0
    ISSN 1120-9763
    ISSN 1120-9763
    DOI 10.19191/EP20.4.P205.050
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  9. Article ; Online: Re: Expected Monetary Impact of Oncotype DX Score-Concordant Systemic Breast Cancer Therapy Based on the TAILORx Trial.

    Giorgi Rossi, Paolo / Paci, Eugenio

    Journal of the National Cancer Institute

    2019  Volume 112, Issue 3, Page(s) 318–319

    MeSH term(s) Humans ; Neoplasm Recurrence, Local ; Receptors, Estrogen
    Chemical Substances Receptors, Estrogen
    Language English
    Publishing date 2019-06-18
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2992-0
    ISSN 1460-2105 ; 0027-8874 ; 0198-0157
    ISSN (online) 1460-2105
    ISSN 0027-8874 ; 0198-0157
    DOI 10.1093/jnci/djz125
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  10. Article ; Online: Recommendation without experts? Epistemological implications in the development of screening guidelines.

    Giorgi Rossi, Paolo

    Preventive medicine

    2016  Volume 83, Page(s) 22–25

    Abstract: Controversies concerning mammographic and cervical cancer screening with HPV-DNA recommendations lead to an analysis of the role played by a knowledge of disease epidemiology, natural history and pathogenesis in producing sound recommendations. This ... ...

    Abstract Controversies concerning mammographic and cervical cancer screening with HPV-DNA recommendations lead to an analysis of the role played by a knowledge of disease epidemiology, natural history and pathogenesis in producing sound recommendations. This analysis calls into question the decision to exclude experts on the specific topic from guideline and recommendation development because such experts may bring prejudices or even conflicts of interest to the debate. According to this approach, methodology is the only factor that guarantees the soundness of evidence assessment. The assumption underlying such an epistemological point of view is that evidence is "absolute," i.e. not linked to any interpretative model or conjecture. Actually, any form of scientific knowledge includes conjectures, which by definition are not demonstrable, in order to interpret evidence. Even as we assess evidence, we need to select or formulate conjectures that explain most of the evidence available. In order to decide on such conjectures, we require individuals who are familiar with the epidemiology and the aetiology of the disease, as well as with the rationale behind the technologies or interventions proposed. Finally, we need individuals who know the strengths and the weaknesses of alternative conjectures; in other words, we also require content experts.
    MeSH term(s) Conflict of Interest ; Early Detection of Cancer ; Evidence-Based Medicine ; Female ; Humans ; Knowledge ; Practice Guidelines as Topic ; Uterine Cervical Neoplasms/diagnosis
    Language English
    Publishing date 2016-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 184600-0
    ISSN 1096-0260 ; 0091-7435
    ISSN (online) 1096-0260
    ISSN 0091-7435
    DOI 10.1016/j.ypmed.2015.11.025
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