脏活检实用:从脏精密医学项目中的患者和临床医生的观点
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Lauren Bernard1, Ashley R Wang2, Steven Menez2
1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Kidney medicine
|September 29, 2023
概括
活检显著影响患者对诊断和治疗的理解,影响生活方式和药物决定. 整合患者的观点增强了共享决策和活检的临床实用性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医学诊断 医学诊断 医学诊断
- 以患者为中心的护理
背景情况:
- 关于患者对脏活检的看法存在有限的数据.
- 了解患者的观点对于评估活检的临床效用至关重要.
- 脏精密医学项目 (KPMP) 提供了一个探索这些观点的平台.
研究的目的:
- 探索患者对活检影响的看法.
- 为了比较患者和临床医生对脏活检实用性的观点.
- 了解活检如何影响患者的理解,治疗和生活方式.
主要方法:
- 一项前性队列研究,涉及167名接受脏活检的参与者和58名临床医生.
- 调查进行了活检前和活检后 (28天,参与者6个月;临床医生2周).
- 分析包括卡帕统计数据的一致性,患者观点的主题分析和临床医生评级的统计测试.
主要成果:
- 慢性病患者和糖尿病和高血压的临床医生之间的低病因一致性.
- 84%的参与者报告活检影响了他们对诊断的理解;38%的人报告了药物改变.
- 临床医生对管理效益的看法增加,而预后价值的看法在活检后下降.
结论:
- 患者对脏活检影响的观点应纳入共享决策.
- 增强的活检报告和科医生-病理学家互动可以改善管理和预后价值.
- 为了有效利用脏活检,需要患者和临床医生之间的更大合作.
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