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Methodology for Sputum Induction and Laboratory Processing
Published on: December 17, 2017
軽度不発症のスプレーの最善の管理のための意思決定分析
N Johnson1, J Sutton, J G Thornton
1Department of Obstetrics and Gynaecology, University of Leeds, UK.
Lancet (London, England)
|July 10, 1993
まとめ
軽度の不発症性子宮頸部スプレーを繰り返すことは,子宮頸部がんを予防するために,即時のコルポスコピーの推薦と同じくらい効果的です. この保守的なアプローチは,潜在的コスト・ベネフィットで比較可能な結果を提供し,スクリーニング・プロトコルにおいて慎重に検討することを保証します.
科学分野:
- 婦人科腫瘍学 婦人科腫瘍学
- 公衆衛生スクリーニング
- 意思決定 分析 分析
背景:
- 子宮頸がんのスクリーニングは,子宮頸椎硬化症の検出に依存しています.
- 軽度な硬血症のスプレーの管理決定には,再検査またはコルポスコピーの推薦が含まれます.
- 軽度のディスカリオシスの最適な管理戦略については,不確実性があります.
研究 の 目的:
- 軽度な不発症性子宮頸部スプレーの2つの管理方針の効果とコストを比較するために: 繰り返しスプレーと即時コルポスコピーの推薦.
- 子宮頸がんのスクリーニングプログラムに関する根拠に基づいたガイドラインを策定する.
主な方法:
- 経営方針を比較するために,意思決定分析モデリングを使用した.
- データは,世界の文献から合成され,軽度な不発症のスプレーの英国の監査から得られた.
- 予想される死亡率とコストは,異なるスクリーニング頻度で各政策で計算されました.
主要な成果:
- 5年に一度のスクリーニングによる保守的な再検査政策は,1000人の女性あたり2.0人の癌症例をもたらした.
- スクリーニングを3年毎に減らすことで,これは1000人当たり1.6人に減り,即時コルポスコピーの推薦率に匹敵しました.
- 保守的な戦略と比較して,追加の1つの癌を予防するために,2500人の女性を推薦し,即時のコルポスコピーの推薦が必要でした.
結論:
- 子宮頸部スプレーを繰り返し行うことは,軽度の難経症に対する即時コルポスコピーのように実行可能で,ほぼ有効な戦略です.
- 保守的な政策の費用対効果は,再発する異常率に敏感である.
- 国内スクリーニングガイドラインを変更する前に,ディスカリオシス率の現地監査が推奨されます.
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