了解新型肺结核诊断测试的增值
Nimalan Arinaminpathy1, David Dowdy2
1MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, Norfolk Place, London W2 1PG, UK.
Nature
|December 4, 2015
概括
评估新的结核病诊断测试需要关注其增量价值,而不仅仅是准确性. 这种方法考虑患者的行为和卫生系统, 以更好地制结核病的传播.
科学领域:
- 公共卫生
- 传染病流行病学
- 医疗诊断
背景情况:
- 结核病 (TB) 仍然是全球死亡的主要原因,未被诊断的病例加剧了这种情况.
- 目前的诊断测试评估可能高估了它们对结核病传播的影响.
- 患者因素和传播动态影响诊断测试的有效性.
研究的目的:
- 建议对新型结核病诊断试验进行评估.
- 定义和测量诊断测试在制结核病传播方面的增值.
- 开发一个统一的框架来评估诊断测试在人口层面的影响.
主要方法:
- 开发一种新的,简化的结核传播模型.
- 诊断试验增值值的评估超出了灵敏度和特异性.
- 患者行为,疾病自然史和卫生系统因素的整合.
主要成果:
- 新型结核病诊断测试的增量值受准确性,患者行为,疾病自然史和卫生系统的影响.
- 提出了一个基于人口水平结果的诊断测试评估框架,例如避免传播.
- 该模型展示了额外的数据如何为有效的实施策略提供信息.
结论:
- 在评估新的结核病诊断测试时,必须建立一个人口层面的增值框架.
- 诊断测试的影响取决于超出内在准确性的因素.
- 这种方法可以更有效地实施防治结核病的诊断技术.
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