时间去实施低价值的癌症查实践:一个叙事审查
Jennifer H LeLaurin1, Kathryn Pluta2, Wynne E Norton3
1Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA jlelaurin@ufl.edu.
BMJ quality & safety
|May 20, 2025
概括
停止实施低价值癌症查需要时间,宫查需要4-16年. 许多低价值的实践缺乏足够的数据来跟踪,阻碍了医疗保健的效率.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 预防医学 预防医学
背景情况:
- 低价值的癌症查实践导致医疗保健浪费和患者痛苦.
- 基于证据的实践需要15年的时间才能实施;不再实施的时间表是不太了解的.
- 停止实施无效查对于优化癌症控制至关重要.
研究的目的:
- 评估停止实施特定低价值癌症查实践所需的时间.
- 识别跟踪癌症查停止实施的障碍.
- 为改善癌症护理提供和降低成本的战略提供信息.
主要方法:
- 对六项美国预防服务特别工作组"D级"癌症查实践的证据审查.
- 测量时间从指南发布到实践使用减少50%.
- 评估使用国家监测数据和来自美国的同行评审文献.
主要成果:
- 对于21岁以下的女性来说,子宫癌查取消实施需要4年,对于65岁以上的女性来说,需要16年.
- 自2012年以来,男性≥70岁前列腺癌查尚未实现50%的停止实施.
- 没有足够的证据来衡量卵巢,甲状腺,丸和胰腺癌查的脱落.
结论:
- 取消低价值癌症查的实施是一个缓慢的过程,因查类型和人群而异.
- 对低价值查实践的监测很少,这阻碍了跟踪和评估.
- 系统地测量退出实施对于改善患者治疗结果和医疗保健效率至关重要.
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