评估诊断成像的临床价值所需的证据类型
Carly Stewart1, Matthew S Davenport2,3, Diana L Miglioretti4
1Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco.
NEJM evidence
|June 25, 2024
概括
先进的诊断成像证据往往缺乏患者结果数据,导致低价值护理. 随机试验对于证明成像技术的安全性和有效性至关重要.
科学领域:
- 医疗成像医学成像
- 医疗保健服务研究 医疗服务研究
- 临床试验 临床试验
背景情况:
- 目前对先进诊断成像的证据主要依赖于准确性研究,而不是患者结果试验.
- 这种差距导致了低价值护理的增加以及对未知的益处和危害的测试的伦理担忧.
研究的目的:
- 突出需要强大的临床试验来验证先进的诊断成像.
- 强调从成像发现中量化疾病风险的必要性,以基于证据的管理.
主要方法:
- 审查支持先进诊断成像的证据.
- 确定对新成像技术和偶然发现的研究需求.
主要成果:
- 诊断准确性研究不足以证明改善患者的治疗结果.
- 图像测试的广泛使用,其益处和危害不完全清楚,正在扩大.
结论:
- 随机临床试验对于批准新的成像技术至关重要.
- 需要进行大型队列研究,以管理偶然发现并减少低价值护理.
- 尽量减少低价值成像需要临床医生,医学协会和公众之间的合作.
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