低身長と成長ホルモン療法. 医師の推薦パターンに関する全国的な研究
L Cuttler1, J B Silvers, J Singh
1Department of Pediatrics, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.
JAMA
|August 21, 1996
まとめ
小児内分泌学者は,医療,社会,知覚の要因を考慮して,GH欠乏のない矮小児に成長ホルモン (GH) を推奨することが多い. GH療法に対する医師の推奨は,個々の患者の特徴と外部からの影響に基づいて大きく異なります.
科学分野:
- 小児内分泌学について
- 成長ホルモン療法 成長ホルモン療法
- ショートステータス管理について
背景:
- 成長ホルモン (GH) は特定の状態で承認されていますが,古典的なGH欠乏症 (非GHD) の低い子供での使用は論争の的です.
- 専門家の意見は,非GHDの低身長に対するGH療法の適切性について異なります.
研究 の 目的:
- 短い非GHDの子供に対してGHの使用に関する現在の専門家の意見と勧告を評価する.
- これらの症例におけるGH治療に関する小児内分泌学者の決定に影響を与える要因を理解する.
主な方法:
- 534人の米国小児内分泌科医を対象に全国調査を実施し,短身管理を専門としています.
- この調査は,さまざまな臨床シナリオにおけるGH治療の専門家による推奨を分析し,81.3%の応答率を達成した.
主要な成果:
- 医師は,GH治療を受けた患者の42%がGHD以外の症状を持っていたと報告しました.
- 短身の非GHD児におけるGHの推奨値は,子供の成長,家族の希望,費用,および医師の信念に基づいて著しく変化しました (1%から74%).
- 医学的,社会的,知覚的要因は独立してGHの推奨決定に影響を与えた.
結論:
- 多くの小児内分泌学者は,選択された短身の非GHDの子供に対するGH治療をサポートし,現在のFDAが承認した用途を超えて拡大しています.
- GHの処方決定は,臨床データ,患者/家族の要因,医師の認識の複雑な相互作用を伴う.
- 将来のGH利用は,臨床試験のデータ,患者/家族の好み,費用,医師の見解によって決定されます.
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