辅助诊断测试与痴呆症结果的关联
Josephine E Lindhout1, Edo Richard1, Melanie Hafdi2
1Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, The Netherlands; Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
概括
辅助性痴呆的测试,如CT/MRI,EEG,或CSF没有改变患者的结果或成本. 神经心理检查 (NPE) 与更长的生存和更低的成本有关,而PET/SPECT扫描增加了成本.
科学领域:
- 神经学 神经学
- 卫生经济学 卫生经济学
- 诊断医学 诊断医学
背景情况:
- 痴呆症诊断缺乏治愈治疗方法,使辅助诊断测试的有用性变得不清楚.
- 评估诊断测试对患者结果和医疗保健支出的影响至关重要.
研究的目的:
- 调查特定诊断测试与痴呆患者出现不良结果的时间之间的关联.
- 分析辅助测试对与痴呆症护理相关的医疗保健成本的影响.
主要方法:
- 荷兰的一项全国性基于登记的队列研究,涉及13,312名在2018年被诊断为痴呆症患者.
- 对接受CT/MRI,NPE,PET/SPECT,EEG或CSF测试的患者的结果和成本进行比较,与倾向性得分匹配的对照进行比较.
主要成果:
- 神经心理学检查 (NPE) 与更长的时间导致不良结果和更低的医疗保健成本有关.
- 与对照组相比,CT/MRI,EEG和CSF测试在时间到不良结果之间没有显著差异.
- PET/SPECT成像与较短的时间与糟糕的结果,但更高的医疗保健成本有关;CSF测试也增加了成本.
结论:
- NPE可能与更好的结果和更低的成本有关,可能是由于因指示而混.
- 神经成像 (CT,MRI,SPECT/PET),EEG和脑脊髓检测没有显示出痴呆症诊断的改善结果或降低成本.
- 临床检查仍然是痴呆症诊断的重要点,辅助测试显示了可变的实用性和成本影响.
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