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在澳大利亚的全科医院,初级保健患者出现意想不到的体重减轻:复制诊断准确性研究的复制
Alex Lee1, Lucas de Mendonça2, Damien McCarthy2
1Department of General Practice and Primary Care, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia alexalee@unimelb.edu.au.
BMJ open
|July 29, 2025
概括
意外减肥 (UWL) 在澳大利亚初级保健中与英国研究相比,癌症的积极预测值 (PPV) 较低. 然而,PPV随着年龄和异常血液检测结果的增加而增加,在某些人口统计学群体中仍然显著.
科学领域:
- 主要护理医学 医疗保健
- 瘤学 诊断 诊断 瘤学
- 流行病学 流行病学
背景情况:
- 意外减肥 (UWL) 是一个令人担忧的症状,需要准确的诊断评估.
- 之前在英国进行的研究确定了UWL后癌症诊断的积极预测值 (PPV).
- 在澳大利亚的初级保健中复制这些发现对于理解区域诊断准确性至关重要.
研究的目的:
- 计算在六个月内癌症诊断的PPV,用于澳大利亚的初级保健患者呈现UWL.
- 为了将这些PPV与之前在英国研究中报告的PPV进行比较.
- 确定影响癌症UWLPPV的人口和临床因素.
主要方法:
- 一项诊断准确性研究,利用来自Patron初级保健数据库的回顾性数据,与住院病例和维多利亚州癌症注册表相关联.
- 纳入标准:18岁以上的患者,没有先前的癌症诊断或减肥干预措施,在2007年7月至2022年2月之间出现.
- 在第一个记录的UWL呈现后的六个月内为任何癌症诊断计算PPV.
主要成果:
- 澳大利亚队列中的PPV通常低于英国研究报告的PPV.
- 在60岁以上的男性非吸烟者,70岁以上的女性吸烟者和70岁以上的所有男性中观察到显著的PPV (> 3%).
- 60-79岁的患者血液检测异常显示PPV始终在3%以上,在异常结果的患者中总体达到35%.
结论:
- 虽然比英国的数字低,但澳大利亚的UWL癌症的PPV仍然具有临床意义,特别是在老年人群中.
- 随着年龄的增长和血液检测结果异常的存在,与更高的PPV相关.
- 这些发现强调了在诊断工作中考虑UWL的重要性,特别是与其他临床指标结合使用.
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