公共卫生 公共卫生
Marie-Jeanne Kergoat1,2, Juan-Manuel Villalpando1,2, Bernard-Simon Leclerc2,3
1Faculte de medecine, Universite de Montreal, Montreal, QC, Canada.
这次审查发现,虽然阿尔茨海默病的诊断正在转向生物标志物,但临床标准仍然对大型研究至关重要. 标准化这些标准对于在不同人群中进行一致的阿尔茨海默病研究至关重要.
科学领域:
- 神经学 神经学
- 流行病学 流行病学
- 老年学是指老年学的学科.
背景情况:
- 阿尔茨海默病 (AD) 诊断正在向基于生物标志物的定义发展,超越了传统的临床标准.
- 阿尔茨海默氏症的长期临床前阶段带来了诊断挑战,特别是在不同研究队伍中比较数据时.
- 目前的队列研究通常依赖于各种方法,使得一致的AD进展跟踪复杂化.
研究的目的:
- 系统地审查和比较阿尔茨海默病临床连续的前性人口研究中使用的诊断标准.
- 评估跨队列的诊断标准对齐,重点关注患有阿尔茨海默病的老年人.
- 在阿尔茨海默病研究中确定诊断方法的趋势和变化.
主要方法:
- 从2000年开始对队列研究进行系统审查,对50-85岁的社区成年人进行至少3年的随访.
- 搜索了主要的数据库 (MEDLINE,Embase,Cochrane,PsycINFO,Web of Science) 相关的原始研究.
- 使用NIH质量评估工具对观察性队列和跨部门研究进行评估的方法质量.
主要成果:
- 从3297篇初步论文中,选出了28项涵盖25个队列的研究.
- 在阿尔茨海默病晚期的诊断标准中观察到趋同,但在早期阶段仍然存在变化.
- 很少有队列 (5/25) 检查了阿尔茨海默病进展的全谱.
结论:
- 临床诊断标准对于阿尔茨海默病研究仍然很有价值,特别是在大规模或资源有限的环境中,尽管基于生物标志物的诊断趋势越来越强.
- 采用标准化的临床标准对于对阿尔茨海默病的大型人群研究至关重要.
- 该审查突出了当前标准中的共识和分歧领域,为未来阿尔茨海默病标准化诊断工具的开发提供了信息.
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