旨在提高肺癌查率的干预措施的有效性:系统性审查和元分析
Shina Satoh1,2,3, Manav Shah1,3, Mitchell Sungelo1,2,3
1Northwell Health, 2000 Marcus Ave., Suite 300, New Hyde Park, NY, 11042-1069, USA.
Journal of general internal medicine
|November 13, 2024
概括
促进肺癌查 (LCS) 参与的干预措施在整体上取得了有限的成功. 然而,多障碍干预措施可以提高低剂量计算机断层扫描 (LDCT) 查率.
科学领域:
- 肺部医学 肺部医学
- 公共卫生 公共卫生
- 临床试验 临床试验
背景情况:
- 低剂量计算机断层扫描 (LDCT) 的肺癌查 (LCS) 患者参与率较低是美国的一个重要问题.
- 提高LCS吸收的有效策略对于早期肺癌检测至关重要.
研究的目的:
- 系统地审查和评估旨在增加患者参与LCS的干预措施的有效性.
主要方法:
- 从1946年到2021年10月发表的综合系统审查和研究的元分析.
- 搜索了多个数据库,包括MEDLINE,Embase,Cochrane和临床试验.gov.gov.
- 包括五项随机对照试验和一项前性观察性研究,分析治疗意图数据并评估偏差风险.
主要成果:
- 总体而言,干预措施并没有显著改善LCS LDCTs所执行的比例 (RR 1.30 [95% CI 0.74, 2.29),观察到高异质性 (I2=91%).
- 小组分析表明,针对多个障碍的多步干预措施,与单步干预措施 (RR 0.99 [95% CI 0.89, 1.10) 相比,显示出显著的益处 (RR 2.68 [95% CI 1.77, 4.05]).
- 五个RCT中有三项表现出一些担忧或偏见的高风险,研究主要包括非多样化的群体.
结论:
- 增加LCS参与率的干预措施的证据受到研究数量少,参与者群体不多样化以及偏见的重大风险的限制.
- 虽然整体干预措施并不有效,但解决查多重障碍的策略显示出改善LCS吸收的潜力.
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