诊断产量与诊断准确性对外周肺部活检评估:证据支持未来实用终点的证据
Kaele M Leonard1, See-Wei Low2, Cristina Salmon Echanique1
1Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
Chest
|December 24, 2023
概括
对支气管镜检查的保守的诊断产量定义,不包括非特异性的良性结果,接近诊断准确度. 这种方法可以更快地报告新设备的诊断效用.
科学领域:
- 肺部医学 肺部医学
- 诊断成像 诊断成像 诊断成像
- 干预性肺病学 干预性肺病学
背景情况:
- 对诊断产量和准确性终点的不一致使用,阻碍了对先进支气管镜技术的比较.
- 目前用于评估诊断准确性的方法需要长时间的随访,延迟新型设备的性能报告.
研究的目的:
- 评估一个保守的诊断产量定义是否接近诊断准确度.
- 确定这个定义是否可以作为未来诊断实用性研究的有用结果.
主要方法:
- 将常用的诊断产量定义应用于450个导航支气管镜手术的前性数据.
- 诊断产量计算与诊断准确性的比较,经过2年的临床随访证实.
- 将非恶性活检结果分类为特异良性,非特异良性或正常肺部.
主要成果:
- 恶性癌症的患病率为60.9%.
- 保守的定义 (恶性或特定良性发现) 与诊断准确度相比,显示差异仅为0.7%.
- 不特定的良性发现对恶性瘤具有很高的错误阴性率 (38.7%).
结论:
- 一个保守的诊断产量定义非常接近高级诊断支气管镜的诊断准确性.
- 这种定义允许及时传播可靠的诊断实用数据,这对于快速发展的技术至关重要.
- 排除非特异性良性诊断可以最大限度地减少与长期随访相关的延迟.
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