不安検診:米国の予防サービスタスクフォースのための証拠報告と体系的レビュー
Elizabeth A O'Connor1, Michelle L Henninger1, Leslie A Perdue1
1Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, Oregon.
JAMA
|June 20, 2023
まとめ
基本医療における不安のスクリーニングは 明確な効果を示さなかったが 治療は効果的だった GAD-7スクリーニングツールは,一般的不安障害の検出に適した精度を示した.
科学分野:
- 主要治療薬
- 精神科
- 証拠 に 基づく 実践
背景:
- 主要なケア施設では不安が蔓延しており 患者の負担を大きくしています
- 効果的なスクリーニングと治療戦略は この集団における不安の管理に不可欠です
研究 の 目的:
- プライマリケアにおける不安のスクリーニングと治療の利害を評価する.
- 不安を検知する機器の精度を評価する.
主な方法:
- 英語のオリジナルの研究と体系的なレビューの体系的なレビュー.
- 2022年11月まで MEDLINE,PsychINFO,コクラン図書館で検索しました.
- スクリーニング,治療,診断の正確性に関する研究が含まれ,品質は独立に評価された.
主要な成果:
- 2つのスクリーニング研究では,効果は認められなかった. 汎用不安障害 (GAD) - 7の計測器は適切な精度を示した (感度0. 79,特異性0. 89).
- 大量の証拠が不安治療の利点を支持しており,心理学的介入は,症状の重度における -0.41の標準化された平均差を示しています.
- 他のスクリーニングツールや不安障害の証拠は限られている.
結論:
- 不安検診プログラムの利益や害について 十分な証拠はありません.
- 不安治療の利点は 明らかです
- GAD-7のような不安スクリーニング装置は,一般的不安障害を検出するのに適した精度を示しています.
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