新しい結核診断検査の付加価値を理解する
Nimalan Arinaminpathy1, David Dowdy2
1MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, Norfolk Place, London W2 1PG, UK.
Nature
|December 4, 2015
まとめ
新しい結核診断検査の評価は 精度だけでなく 付加的な価値に 焦点を当てる必要があります このアプローチでは 結核の感染を抑制するために 患者の行動や医療システムを考慮します
科学分野:
- 公衆衛生
- 感染症 疫学
- 医療診断
背景:
- 結核 (TB) は世界の主要な死因であり,診断されていない症例によって悪化しています.
- 現在の診断試験の評価では 結核の感染への影響が過大評価されている可能性があります
- 患者の要因と伝播ダイナミクスは,診断試験の有効性に影響します.
研究 の 目的:
- 新型結核診断検査の評価に変化を提案する.
- 結核の感染抑制における 診断検査の付加価値の定義と測定
- 集団レベルでの診断テストの影響を評価するための統一された枠組みを開発する.
主な方法:
- 新しく簡素化された結核感染モデルの開発
- 感度と特異性を超えた診断試験のインクリメンタル値の評価
- 患者の行動,病気の自然経歴,および健康システム要因の統合.
主要な成果:
- 新型の結核診断検査の 増加価値は 精度,患者の行動,病気の自然経歴,および健康システムによって影響されます.
- 予防された感染などの集団レベルでのアウトカムに基づいて診断テストの評価のための枠組みが提示されています.
- このモデルは,追加のデータが効果的な実施戦略にどのように役立つかを示しています.
結論:
- 新しい結核診断検査の評価には 人口レベルでのインクリメンタル・バリュー・フレームワークが不可欠です
- 診断試験の影響は,本質的な精度を超えた要因に左右されます.
- このアプローチは,結核の制御のための診断技術のより効果的な実施につながります.
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