间歇性肺病患者的诊断途径:对患者和医生的混合方法研究
Amanda Grant-Orser1,2, Charlotte Pooler3,4, Nathan Archibald5
1Department of Medicine, Division of Respirology, University of Calgary, Calgary, Alberta, Canada amanda.grant-orser@mail.mcgill.ca.
BMJ open respiratory research
|April 30, 2024
概括
诊断间歇性肺部疾病 (ILD) 需要太长时间. 延迟往往发生在看到专家之前,由于诸如迟到的初级保健访问和错误诊断等因素. 提高认识和获取机会可以加快ILD诊断.
科学领域:
- 肺部病理学 肺部病理学
- 诊断医学 诊断医学 诊断医学
- 医疗保健系统研究 医疗保健系统研究
背景情况:
- 间歇性肺病 (ILD) 存在复杂的诊断挑战.
- 及时和准确的诊断对于有效的患者管理至关重要.
- 目前对ILD的诊断途径通常是漫长和分散的.
研究的目的:
- 描述间歇性肺部疾病的诊断护理途径.
- 识别导致ILD诊断延迟的障碍物.
- 探索改善诊断及时性和准确性的潜在解决方案.
主要方法:
- 采用混合方法方法,结合定量和定性数据.
- 定量数据包括对97名患者的病历审查.
- 通过患者和医生调查 (分别为n=70和n=20) 和焦点小组收集了定性数据.
主要成果:
- 从症状发作到ILD诊断的中位时间为12.0个月;46%的人在一年内被诊断出来.
- 在最初的CT扫描和呼吸学转诊之间观察到显著的延迟 (中位数为2.4个月).
- 患者和医生报告了包括延迟初级保健呈现,错误诊断和长期专家等待时间在内的挑战.
结论:
- 与患者和系统相关的因素显著导致ILD的诊断延迟.
- 大多数诊断延迟发生在转诊呼吸学之前.
- 建议包括提高ILD意识,提前提供初级保健,加速成像和迅速转诊呼吸学.
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