查测试的使用和滥用
David A Grimes1, Kenneth F Schulz
1Family Health International, PO Box 13950, Research Triangle Park, NC 27709, USA. dgrimes@fhi.org
Lancet (London, England)
|March 19, 2002
概括
查测试可以识别患病风险较高的个体,但其有效性取决于仔细的解释. 了解测试有效性和疾病患病率对于准确的结果和避免不必要的干预至关重要.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 查测试被广泛使用,但往往被误解.
- 通过查进行早期诊断具有潜在的好处,但也有缺点.
研究的目的:
- 澄清选试验的原则和解释.
- 突出影响选试验有效性和实用性的因素.
主要方法:
- 对选试验有效度指标的讨论:灵敏度,特异性和预测值.
- 分析疾病患病率如何影响测试性能.
- 考虑顺序测试和偏差 (交付时间,长度).
主要成果:
- 测试有效度指标与连续变量相反相关;切断位置至关重要.
- 低患病率显著降低了查测试的积极预测值.
- 随机对照试验对于减轻偏见和准确评估查计划有效性至关重要.
结论:
- 查可以改善健康结果,这是宫细胞学数据表明的.
- 查测试的错误应用或错误解释可能导致不良影响,包括心理痛苦和资源浪费.
关键词:
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