无症状成年人的预测生物标志物:机会,风险和通用实践指南
Christian J Wiedermann1, Giuliano Piccoliori1, Adolf Engl1
1Institute of General Practice and Public Health, Claudiana-College of Health Professions, 39100 Bolzano, Italy.
Diagnostics (Basel, Switzerland)
|January 28, 2026
概括
生物标志物在预防中的使用正在增长,但许多生物标志物缺乏临床实用性. 一般医生必须仔细解释结果,以确保公平,以患者为中心的护理,并避免潜在的伤害.
科学领域:
- 生物医学诊断和预防医学.
- 初级保健和卫生服务研究.
背景情况:
- 基于生物标志物的预防正在扩大,这是由于分子诊断和直接向消费者 (DTC) 测试.
- 一般医生 (GPs) 面临的挑战是,在既定指导方针之外解释生物标志物结果.
- 这影响了初级保健机构的沟通,资源使用和公平护理.
研究的目的:
- 审查无症状成年人生物标志物的预测价值,局限性和影响.
- 评估神经退行性,心血管和衰老疾病的生物标志物.
- 为生物标志物在预防医学中的负责任整合提供信息.
主要方法:
- 叙事综述综合了来自人口研究,指导方针和通信研究的证据.
- 专注于多基因风险评分,DTC遗传测试,以及特定的心血管/神经退行性标志物.
- 评估分析有效性,临床有效性和预防性使用的临床实用性.
主要成果:
- 一些生物标志物 (例如hs-cTn,NT-proBNP,Lp(a),CAC,p-tau) 显示出强大的预测有效性.
- 许多销售的生物标志物缺乏临床实用性,可操作的益处,或在初级保健中表现不佳.
- 意想不到的后果包括过度诊断,痛苦和扩大健康不平等.
结论:
- 少数生物标志物符合一般实践中预防性使用的标准.
- 一般医生对于将结果置于背景,共享决策和减轻危害至关重要.
- 负责任的整合需要明确的沟通,道德保障,强有力的证据和系统支持.
关键词:
生物标志物 生物标志物直接向消费者进行测试.伦理考虑 伦理考虑一般的医生一般的医生过度诊断是一种过度诊断.多基因风险得分的多基因风险得分.预防医学是预防医学.主要护理是一级医疗保健.风险沟通风险沟通是什么更多相关视频
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