在内部医学中存在诊断错误风险的非典型表现:范围审查
Yukinori Harada1, Ren Kawamura2, Masashi Yokose2
1Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Mibu, Japan. yharada@dokkyomed.ac.jp.
非典型的疾病表现有助于内部医学的诊断错误. 这次审查发现定义的差异很大,促使建立了一个新的分类系统,以提高理解并减少错误.
科学领域:
- 内部医学 内部医学
- 诊断错误研究研究 诊断错误研究
- 临床表现分析 临床表现分析
背景情况:
- 与诊断错误相关的非典型疾病表现的了解很少.
- 需要改进非典型表现的定义,以提高诊断准确度.
- 本研究的重点是如何在内部医学的诊断错误文献中定义非典型表现.
研究的目的:
- 描述内部医学诊断错误研究中使用的非典型表现的定义.
- 确定与诊断错误风险增加相关的非典型表现模式.
- 提出一个新的框架来分类非典型的呈现.
主要方法:
- 对成年内科病人的非典型表现和诊断错误的论文进行系统审查.
- 在多个数据库 (MEDLINE,科学网,CINAHL,Embase,Cochrane,谷歌学者,MedRxiv) 进行的搜索,截至2025年7月31日.
- 定性内容分析,以开发临床表现的新分类方法.
主要成果:
- 综述中包括了56篇论文.
- 30项研究提供了非典型表现的定义,显示出显著的异质性.
- 开发了一种新的分类方法,即PSUC (初级,暗示性,不常见,驼) 方法,确定了诊断错误的四种高风险模式.
结论:
- 目前在诊断错误研究中对非典型呈现的定义非常异质.
- 拟议的PSUC方法提供了一种结构化的方法来分类异常呈现.
- 需要进一步的研究来调查PSUC方法在临床实践和诊断错误减少中的有用性.
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