在医疗保险人口中低剂量计算机断层扫描查的积极结果的诊断后续检查
Paul F Pinsky1, Gerard Silvestri2, Raymond Osarogiagbon3
1National Cancer Institute, Bethesda, Maryland (P.F.P., E.M., L.E., P.D.-R.).
Annals of internal medicine
|December 15, 2025
概括
阳性肺癌查后的随访护理有所不同,约60%的人接受了符合指南的护理. 许多患者接受的密集护理程度低于推水平,这凸显了肺癌查后改善诊断评估的必要性.
科学领域:
- 肺部病理学 肺部病理学
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 阳性肺癌查后的诊断评估对患者的治疗结果至关重要.
- 在肺癌查结果呈阳性后,对后续诊断程序的数据有限.
研究的目的:
- 评估在肺癌查结果呈阳性后诊断测试在临床实践中的使用情况.
- 评估遵守指导方针一致的护理,并确定随访强度的变化.
主要方法:
- 对65岁以上的个人进行了回顾性队列研究,首次肺癌查结果呈阳性,Medicare服务费用覆盖.
- 对诊断测试 (成像,侵入性手术) 在阳性查后一年内使用的分析.
- 后勤回归用于识别与指导方针相比较较少或更多的重症监护相关的因素.
主要成果:
- 59.7%的参与者接受了与指南一致的护理,随着肺RADS得分的增加.
- 32.3%的患者接受的重症监护程度低于推水平,在特定的人口群体中,这一比例更高.
- 12.4%的人在一年内被诊断出患有肺癌;在没有癌症的人群中,侵入性手术并不常见.
结论:
- 大约60%的患者在阳性肺癌查后接受了符合指导方针的随访.
- 很大一部分 (32.3%) 接受了不那么密集的护理,这表明诊断评估中的潜在差距.
- 在没有肺癌的患者中,侵入性手术的低率表明该小组的适当使用.
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