评估新的结直肠癌非侵入性查测试的有效策略:指导原则
Robert S Bresalier1, Carlo Senore2, Graeme P Young3
1Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Gut
|July 18, 2023
概括
新的结肠直肠癌 (CRC) 查测试需要有效的评估. 经过修订的四阶段方法,使用测试阳性值的比较有效性和灵活性,可以预测健康影响.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 新兴的结肠直肠癌 (CRC) 查的非侵入性测试由于进行死亡率降低试验的困难,对其采用提出了挑战.
- 技术进步和生物标志物识别需要重新评估评估新CRC查试验的原则.
研究的目的:
- 修订和建立新的原则,用于评估新的非侵入性结肠直肠癌查测试.
- 提出一个结构化,分阶段的方法来评估新CRC查技术的有效性和影响.
主要方法:
- 一个多学科的专家小组使用共识方法正式修订了现有原则,导致了12个新陈述的原则.
- 提出了四个阶段的评估策略,从歧视评估 (第一阶段),准确度估计 (第二阶段),意图选结果 (第三阶段) 和长期监测 (第四阶段) 开始.
- 作为非侵入性测试的比较剂,建议使用便免疫化学测试 (FIT),结肠镜仍然是诊断标准.
主要成果:
- 为评估新的非侵入性CRC查测试制定了12条修订后的原则.
- 灵活的四阶段方法允许调整测试阳性值,以满足各种查目标和监管要求.
- 第三阶段和第四阶段的研究对于生成真实世界的数据至关重要,以建模新测试对CRC死亡率和发病率的影响.
结论:
- 一个严格的,分阶段的和比较的评估框架使新的非侵入性结肠直肠癌查测试能够有效地评估.
- 这种方法产生了无偏见的人口数据,这对于预测新型查策略对现实世界的健康影响至关重要.
- 测试阳性度值的灵活性和FIT作为比较器的使用增强了新CRC查技术的评估过程.
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