五十年来临床诊断的敏感性和特异性. 为了理解必要的错误性
R E Anderson1, R B Hill, C R Key
1Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM 87131.
JAMA
|March 17, 1989
概括
这项研究分析了从1930年到1977年的超过5万次尸检,以评估11种疾病的临床诊断准确性. 诊断的准确性各不相同,在某些情况下改善,但在其他情况下恶化,突出了尸检.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 病理学 病理学 病理学
- 临床流行病学临床流行病学
背景情况:
- 临床诊断的准确性对于患者的治疗结果至关重要.
- 尸体解剖为评估诊断准确性提供了明确的方法.
- 诊断准确性的历史趋势没有得到充分的记录.
研究的目的:
- 评估11种特定疾病的临床诊断的敏感性和特异性.
- 分析随着时间的推移 (1930-1977) 诊断准确度的变化.
- 探索尸检在监测和改善临床诊断中的作用.
主要方法:
- 对涉及超过5万次尸检的已发表研究进行系统审查.
- 分析重点集中在1930年至1977年期间.
- 用11种不同的疾病的灵敏度和特异性指标评估诊断准确性.
主要成果:
- 临床诊断准确度在研究疾病中显示出不同的趋势.
- 对于类风湿性心脏病和白血病有所改善.
- 肺结核,腹膜炎和几种癌症的精度下降;其他情况保持不变.
结论:
- 尸体解剖数据可以作为监测随时间推移临床诊断的表现的宝贵工具.
- 通过基于尸检的监视来确定诊断中的系统性弱点是可能的.
- 这种方法可以为管理医疗诊断中固有的错误性制定策略.
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