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临床病史可以区分有机性和功能性消化不良吗?
Paul Moayyedi1, Nicholas J Talley, M Brian Fennerty
1Department of Medicine, McMaster University, Hamilton, Ontario, Canada. moayyep@mcmaster.ca
JAMA
|April 6, 2006
概括
对于临床医生和计算机模型来说,准确诊断有机消化不良仍然是一个挑战. 在接受内镜检查的患者中,这两种方法都不能可靠地区分有机与功能性疾病.
科学领域:
- 胃肠病学 胃肠病学
- 医学诊断 医学诊断 医学诊断
- 医疗信息学 医疗信息学
背景情况:
- 上部胃肠道症状很普遍,影响到40%的人口.
- 精确诊断消化不良症对于适当的调查和治疗至关重要.
研究的目的:
- 系统地审查初级保健医生,胃肠科医生和有机消化不良的计算机模型的诊断准确性.
- 评估临床意见和计算机模型在区分有机与功能性消化不良的有效性.
主要方法:
- 对2003年12月之前发表的研究进行系统的文献综述.
- 包括前性研究,将临床医生/计算机模型诊断与上胃肠内镜结果进行比较.
- 对各种诊断方法的概率比率 (LRs) 的数据提取.
主要成果:
- 分析了15项涉及11,366名患者的研究,42%患有有机性消化不良.
- 临床医生和计算机模型的诊断显示出类似的准确性 (有机消化不良的LR为1.6).
- 具体的诊断,如胃病 (LR 2.2) 和食道炎 (LR 2.4) 的预测值中等.
结论:
- 无论是临床判断还是计算机模型都不能充分区分有机与功能性消化不良.
- 目前的诊断工具,包括包含患者数据的诊断工具,在内镜检查之前在区分疾病类型方面存在局限性.
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