相关实验视频

Updated: Jan 9, 2026

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

前列腺特异抗原查测试的异常标记:一个回归不连续性设计

Patrick Lewicki¹, Ralph Jiang², Archana Radhakrishnan³

¹Department of Urology, University of Michigan, Ann Arbor, MI, USA. lewickip@med.umich.edu.

Journal of general internal medicine

|December 9, 2025

概括

前列腺特异抗原 (PSA) 结果的异常标志显著增加了重复测试,泌尿器科转诊和活检. 这表明,目前的报告可能会导致不适当的前列腺癌评估,强调需要改进标准.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
医学诊断医学诊断医学诊断
公共卫生公共卫生

背景情况:

前列腺特异抗原 (PSA) 检测缺乏定义的正常/异常水平.
"正常的上限" (ULN) 是解释PSA结果的常见但有限的准则.
医生对"异常标志"的依赖可能会驱动护理,而不管个体患者的风险因素.

研究的目的:

调查PSA结果在ULN以上的"异常标记"对后续诊断途径的影响.
为了确定标志性影响是否重复PSA测试,泌尿器科转诊,前列腺活检或MRI.

主要方法:

在38 042个PSA查试验的队列中使用回归断续设计.
分析了"异常"PSA标志和下游医疗干预之间的关联.
根据患者年龄和PSA水平差异进行调整.

主要成果:

2.7%的PSA测试被标记为异常.
"异常"标记显著增加了重复PSA测试 (OR 14.17),泌尿器科转诊 (OR 10.03) 和前列腺核磁共振或活检 (OR 13.61) 的几率.
在对共变量进行调整后,这些关联仍然显著.

结论:

超出ULN的PSA结果的异常标记强烈影响临床决策.
这种做法可能导致前列腺癌风险的过度或低估.
建议制定改进的报告标准,包括针对患者的风险估计.

更多相关视频

Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index

Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index

Published on: January 8, 2020

Author Spotlight: Advancing Prostate Cancer Research Through Improved Tissue Sampling and Biobanking

Author Spotlight: Advancing Prostate Cancer Research Through Improved Tissue Sampling and Biobanking

Published on: November 17, 2023

相关概念视频

Regression Toward the Mean

Regression Toward the Mean

Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when...