在类风湿性关节炎和多肌痛类风湿症中出现过度诊断的风险
Elizabeth Nettleton1, Kylie Carlson2, Michael Putman2
1Rheumatology Services, Rush University Medical Center, Chicago, IL, USA.
The Lancet. Rheumatology
|September 28, 2024
概括
过度诊断,或者诊断一种不会影响生命的疾病,在风湿病学中越来越令人担忧. 对巨细胞动脉炎和间歇性肺病等疾病的查可能会造成更多的伤害而不是好处.
科学领域:
- 类风湿病学 类风湿病学
- 医学诊断 医学诊断 医学诊断
- 患者的治疗结果.
背景情况:
- 过度诊断发生在患者接受的诊断不会影响他们的生活质量或寿命时.
- 查计划旨在在亚临床阶段检测疾病,但可能导致意想不到的后果.
- 最近的建议包括查多肌痛性类风湿症患者的巨细胞动脉炎和类风湿性关节炎患者的间歇性肺病.
研究的目的:
- 检查与风湿病学过度诊断相关的风险.
- 评估风湿病学查干预措施的潜在危害与益处.
- 强调对查效果和患者选择进行严格研究的需要.
主要方法:
- 这一观点讨论了基于当前文献和临床建议的过度诊断的潜在危害.
- 它强调需要随机临床试验和前性队列研究.
- 专注于类风湿性关节炎和多肌痛类风湿性关节炎的查.
主要成果:
- 过度诊断的潜在危害包括偶然发现,增加的医疗费用,过度治疗免疫抑制和心理社会负担.
- 查巨细胞动脉炎在多发性肌痛性风湿症和间歇性肺病在类风湿性关节炎的好处需要仔细考虑这些风险.
- 目前的证据不足以确定这些查举措的风险效益比.
结论:
- 风湿病学中的过度诊断,特别是类风湿性关节炎和多肌痛性风湿病,存在重大风险,必须仔细权衡潜在的益处.
- 进一步的研究,包括随机试验,对于确定查干预措施的真正风险和益处至关重要.
- 识别特定的患者亚组,他们真正会从查中受益,是减轻过度诊断的危害至关重要的.
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