传染病的诊断管理:一个范围审查
Robert Shorten1,2, Kate Pickering1, Callum Goolden1
1Department of Microbiology, Lancashire Teaching Hospitals NHS Foundation Trust, Foundation Trust, UK.
Journal of medical microbiology
|May 9, 2024
概括
诊断管理是一种医疗保健的新方法,它往往以减少测试为重点,而不是提高诊断准确性. 本次审查强调了需要更广泛地定义和应用诊断管辖原则的必要性.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 临床诊断 临床诊断 临床诊断
- 医学实验室科学 医学实验室科学
背景情况:
- 诊断管理的概念正在出现,但在学术文献中缺乏明确,一致的定义.
- 包括世界卫生组织在内的现有定义是广泛的,导致各种解释和应用.
- 这种模糊性需要进行审查,以澄清诊断管理干预的范围和特征.
研究的目的:
- 在文献中发现的诊断管理方法进行分类.
- 通过确定其应用的共同特征和因素来定义诊断管理.
- 解决诊断管理的定义和使用中的不一致性.
主要方法:
- 在2022年10月之前,使用多个数据库搜索进行了全面的范围审查.
- 包括的研究将干预定义为诊断管理,包括观察和实验设计.
- 用叙事方法合成数据,按干预类型分组研究.
主要成果:
- 包括自2017年以来发表的105项研究,其中大多数研究来自美国.
- 干预主要在预分析阶段使用限制性措施 (硬/软停止).
- 重点主要是减少测试量,对测试性能或协议改进的报告有限.
结论:
- 诊断管理经常被狭义地实施,以限制测试,与更广泛的质量改进目标分歧.
- 目前的做法可能与世界卫生组织对全面诊断质量的愿景不一致.
- 可能需要替代框架来有效地分类和指导诊断管理干预.
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