甲状腺超声波的诊断和治疗后果:使用索赔数据的回顾性探索性队列研究
Lisette Warkentin1, Thomas Kühlein1, Johanna Tomandl1
1Allgemeinmedizinisches Institut Erlangen, Uniklinikum Erlangen, Erlangen, Germany.
概括
早期甲状腺超声波 (US) 使用增加检测到的甲状腺结节和随后的诊断程序. 这可能导致过度诊断和过度治疗,因此需要进一步调查常规甲状腺查的必要性.
科学领域:
- 内分泌学 在内分泌学.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 甲状腺超声波 (US) 查经常进行,尽管有指导方针阻止其用于癌症检测.
- 查经常发现良性结节或小乳头癌,引发了人们对过度诊断的担忧.
研究的目的:
- 研究美国早期甲状腺病对德国诊断和治疗程序的影响.
- 分析甲状腺特异性发病率和医疗保健利用率,与标准诊断途径相比,在美国早期.
主要方法:
- 使用德国索赔数据 (2012-2016) 的回顾性观察队列研究.
- 与初始TSH测试和早期甲状腺US (28天内) 的患者和只有初始TSH测试的患者进行了比较.
- 倾向性得分匹配对社会人口统计学因素,症状和先前发病率进行控制. 排除了先前存在低或高甲状腺症的患者.
主要成果:
- 早期的美国与显著更高的甲状腺特异性发病率有关,特别是甲状腺结节.
- 接受美国早期治疗的患者接受了更多与甲状腺有关的随访测试,并更频繁地利用门诊医疗服务.
- 在内部医学,核医学和放射学中观察到使用率的增加.
结论:
- 早期使用甲状腺超声波与诊断的甲状腺发病率增加以及随后的诊断/治疗程序有关.
- 这表明,由于早期查引发的诊断级联,可能存在过度诊断和过度治疗.
- 需要进一步的研究来量化甲状腺结节检测过度诊断的程度.
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