在实地调查中,通过触摸和超声波对甲状腺大小的分类
1Department of Women's and Children's Health, Uppsala University, Sweden.
Lancet (London, England)
|February 16, 2000
概括
1994年世界卫生组织 (WHO) 的喉分类降低了诊断标准,增加了假阳性. 回到1960年的标准,可以在实地调查中以负担得起的价格监测喉.
科学领域:
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
- 诊断的准确性 诊断的准确性
背景情况:
- 子调查评估缺乏.
- 世卫组织1994年的分类重新定义了小甲状腺大小标准的囊.
- 建议进行超声波检查,以准确诊断肠.
研究的目的:
- 评估世卫组织1994年围分类变化的影响.
- 将触摸系统 (旧与新) 与超声波相比较.
- 评估诊断的准确性和围评估的变化.
主要方法:
- 在坦桑尼亚,有225名学童 (7-14岁) 接受了重复超声波和WHO 1960/1994手摸.
- 三名检查人员使用了触摸系统.
- 用超声波作为黄金标准来分析灵敏度,特异性和变异性.
主要成果:
- 1994年的标准通过触摸增加了20-33%的喉诊断.
- 超声波显示的变化略小于触摸 (kappa=0.63对比0.57-0.58).
- 1994年的标准降低了特异性 (76%至29%),但增加了敏感性 (56%至80%).
结论:
- 建议回归1960年的触摸标准 ("大叶大于指的末端手环").
- 接受10%的喉发病率允许成本效益高的实地监测.
- 触摸仍然是一个可行的工具,以适当的标准来评估喉.
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