电子束断层扫描 (有或没有病例管理) 对动机,行为变化和心血管风险概况的影响:一个随机对照试验
Patrick G O'Malley1, Irwin M Feuerstein, Allen J Taylor
1Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. patrick.omalley@amedd.army.mil
JAMA
|May 8, 2003
概括
电子束断层扫描 (EBT) 查没有改善心血管风险. 密集病例管理 (ICM) 在一年内管理风险因素方面比常规护理更有效.
科学领域:
- 预防心血管疾病预防心血管疾病
- 医学成像和诊断 医学成像和诊断
- 健康行为干预措施健康行为干预措施
背景情况:
- 电子束断层扫描 (EBT) 被用作激励工具,但其在行为改变中的有效性尚未研究.
- 心血管疾病仍然是导致死亡的主要原因,需要有效的预防策略.
研究的目的:
- 评估将EBT结果纳入心血管查中的影响.
- 评估EBT是否会影响心血管风险,如果与密集病例管理 (ICM) 或常规护理相结合.
- 为了确定对预计心血管风险的1年影响.
主要方法:
- 进行了一项随机对照试验,采用2x2因数设计.
- 450名无症状的美国陆军人员 (年龄在39-45岁) 被招募.
- 参与者被分配以ICM或常规护理接受EBT结果,或保留EBT结果.
主要成果:
- 与保留结果相比,EBT结果并没有显著改变10年Framingham风险评分 (FRS).
- 与通常护理相比,密集病例管理 (ICM) 显著减少了FRS (-0.06比+0.74,P=.003).
- 在40.2%的患者中观察到心血管风险改善或稳定;只有ICM和风险因素的数量预测了这一结果.
结论:
- 通过EBT进行冠状动脉化查,1年后没有改善可修改的心血管风险因素.
- 密集病例管理在控制心血管风险因素方面表现出优于常规护理的优势.
- 这项研究强调EBT在降低心血管风险方面的激励影响有限.
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