预先转诊的超声波对密码症:仍然很常见,仍然不必要
Grace E Boyd1, Bhaveshkumar Patel1,2,3, Craig A McBride1,2,3,4
1Department of Paediatric Surgery, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Journal of paediatrics and child health
|October 18, 2024
概括
常规超声检查儿童怀疑的密码症是常见的,但缺乏实用性. 图像并不能帮助诊断或管理,造成家长负担和焦虑,没有临床益处.
科学领域:
- 儿科手术 儿科手术
- 诊断成像 诊断成像 诊断成像
- 基于证据的医学基于证据的医学.
背景情况:
- 指导方针建议不要对密码症进行成像.
- 事证据表明频繁使用超声波.
- 该研究评估了成像趋势和丸下降障碍中的效用.
研究的目的:
- 评估怀疑丸下降的儿童的超声波频率,效用和负担.
- 在实施指南之前和之后分析成像使用的趋势.
- 评估成像对诊断和管理的影响.
主要方法:
- 昆士兰儿童医院的前性队列研究.
- 招募了268名丸下降异常的儿童 (2015-2017年和2023-2024年).
- 收集有关人口统计,转诊,成像和手术结果的数据.
主要成果:
- 超声波频率仍然很高 (63.6%-72.8%),并且随着时间的推移而保持不变.
- 增加了家长的负担:17.6%被收费,31.9%错过了工作.
- 超声波显示与外科诊断的一致性较低 (25.0%-30.7%),对诊断或治疗没有贡献.
结论:
- 尽管有指导方针,但超声波经常用于怀疑密码症.
- 图像技术没有临床效用或成本价值.
- 建议避免例行超声波检查,并改进指导方针实施策略.
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