在没有客观测试,生物标志物或参考标准的情况下,制定诊断标准的方法:范围审查
Samuel J White1, Timothy H Barker1, Tracy Merlin2
1Health Evidence Synthesis, Recommendations & Impact (HESRI), School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.
Journal of clinical epidemiology
|November 20, 2025
概括
在没有客观测试的情况下制定诊断标准是不一致的. 这次审查发现,常见方法缺乏透明度,证据和多样化的观点,强调需要方法指导来提高医疗保健的准确性和公平性.
科学领域:
- 医疗信息学 医疗信息学
- 临床流行病学临床流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 诊断标准对于临床决策至关重要,特别是对于缺乏客观测试或生物标志物的疾病.
- 目前发展的诊断标准缺乏标准化的方法指导,导致潜在的不一致性和伤害患者.
研究的目的:
- 识别和描述用于制定对没有客观测试,生物标志物或参考标准的疾病的诊断标准的方法方法.
- 突出需要提高诊断标准开发的透明度和严格性.
主要方法:
- 根据JBI方法和PRISMA-ScR指南进行了范围审查.
- 包括2000年至2024年间发表的研究,描述了在没有客观标准的情况下制定诊断标准的方法.
- 数据综合涉及描述性统计和定性内容分析.
主要成果:
- 包括139项研究;低于最佳的报告阻碍了方法评估.
- 确定了三种主要方法:基于共识 (71%),基于文献和基于初级研究.
- 达成共识的方法,通常是基于Delphi的,在小组 (5%) 和患者咨询 (18%) 中缺乏多样性.
结论:
- 开发诊断标准的方法方法是可变的,报告不一致,并且往往缺乏明确的证据基础.
- 当前的做法可能导致错误的诊断,伤害患者,或不公平的护理.
- 建议制定具体的方法指南,以提高透明度,严谨性和可信度.
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