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在公布了新的多眼术后指导方针后,遵守重复监测的建议
Ulysses S Rosas1, Jennifer Y Pan2,3, Vandana Sundaram4
1Department of Medicine, Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California.
Gastro hep advances
|August 12, 2024
概括
随着时间的推移,先前的结肠镜数据的可用性下降,影响了对低风险腺瘤 (LRA) 后多斑切除术监测指南的遵守. 改善数据访问和更明确的建议对于实施更新的指南至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 临床实践指南 临床实践指南
- 医疗保健服务研究 医疗服务研究
背景情况:
- 美国多个社会工作组在2012年和2020年更新了多叶切除术后监测指南,建议在低风险腺瘤 (LRA) 时隔更长.
- 这些指导方针依赖于先前结肠镜检查的准确数据,以确定适当的监测时间.
- 实施方面的挑战,包括数据的可用性,可能会影响遵守指南.
研究的目的:
- 评估2012年多眼术后指南对临床实践对监测结肠镜检查的影响.
- 在本指南的背景下,评估先前结肠镜数据的可用性.
- 为有效实施2020年多角切除术后指南提供信息.
主要方法:
- 在两个医疗保健系统的监测结肠镜的回顾性分析.
- 收集的数据包括先前的结肠镜信息,当前监测的发现和随后的监测建议.
- 结肠镜检查被分为指南前 (2012年),指南后 (2013年) 和指南后 (2017) 的时间段.
主要成果:
- 以前的结肠镜数据的可用性从指南之前的78%显著下降到指南后的延迟期的61%.
- 推迟等待病理学建议的推迟大幅增加,在推迟的指南后期从6-11%增加到59%.
- 总体上,对监测指南的遵守率仍然低于最佳水平 (54%-67%),并没有改善,对于LRA没有推10年间隔进行正常随访.
结论:
- 之前的结肠镜检查数据并不总是可用,这阻碍了遵守多斑切除术后监测指南.
- 建议经常被推迟,使监控计划复杂化.
- 需要制定战略来改善数据可访问性和简化推流程,以实现2020年指南的最佳实施.
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