甲状腺超声波使用的驱动因素:一项回顾性观察性研究
Cristian Soto Jacome1, Danny Segura Torres1, Jungwei W Fan2
1Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
概括
甲状腺超声波 (TUS) 往往是由偶然的发现和症状驱动的,导致潜在的过度诊断. 根据指南,大约十分之一的TUS订单可能是不合适的.
科学领域:
- 放射学 放射学是一门学科.
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
背景情况:
- 甲状腺超声波 (TUS) 的过度利用有助于甲状腺结节和癌症的过度诊断.
- 了解TUS的触发因素和结果对于优化诊断途径至关重要.
研究的目的:
- 评估订购甲状腺超声波 (TUS) 的主要驱动因素.
- 根据TUS的命令,评估临床轨迹和结果.
- 根据当前的指导方针,识别可能不合适的TUS订单.
主要方法:
- 在2015-2017年期间,对500名接受初始TUS的成年患者进行了回顾性审查.
- 使用框架对TUS标志的分类,识别不合适的订单.
- 对TUS后12个月临床结果的医疗记录的审查.
主要成果:
- 常见的TUS驱动器包括偶然的成像发现 (31.6%),甲状腺症状 (20.4%),和体检异常 (17.2%).
- 在11.2%的案件中,发现了不适当的TUS订单.
- 甲状腺活检发生在23.8%的患者中,癌症检测率为11.8%.
结论:
- 无症状患者的偶然发现,症状和例行检查是TUS的关键驱动因素.
- 很大一部分的TUS可能是不恰当的,强调了需要遵守指南的必要性.
- 该研究强调了明智地使用TUS的重要性,以防止过度诊断.
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