改善及时癌症诊断的干预措施:综合性审查
Mark L Graber1, Bradford D Winters2, Roni Matin3
1Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
Diagnosis (Berlin, Germany)
|October 18, 2024
概括
癌症诊断延迟影响了许多患者. 本综述强调了乳腺,肺癌和结直肠癌诊断的错失机会,并提出了改善及时检测的干预措施.
科学领域:
- 在瘤学瘤学.
- 医疗保健的质量和安全
- 诊断医学 诊断医学
背景情况:
- 癌症影响了超过三分之一的美国居民.
- 大约20%的患者经历了延迟或错过的癌症诊断.
- 门诊护理设置是这些诊断错误的常见环境.
研究的目的:
- 审查在门诊护理中错过或延迟癌症诊断的因素.
- 确定基于证据的干预策略.
- 专注于乳腺癌,肺癌和结直肠癌的诊断.
主要方法:
- 493个出版物的综合性审查.
- 诊断途径的分析,包括查后续,偶然发现和症状呈现.
- 综合有关促成因素和干预措施的证据.
主要成果:
- 诊断延迟发生在多种途径上:异常的测试结果,偶然的发现和非特异性症状.
- 后续过程中的失败是诊断错误的重要原因之一.
- 针对"关闭循环"的干预措施有望改善诊断的及时性.
结论:
- 在癌症诊断中错过的机会在门诊护理中很普遍.
- 提高患者参与度,利用"安全网",利用健康信息技术可以减轻诊断延迟.
- 系统干预对于减少延迟癌症诊断造成的伤害至关重要.
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