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Methodology for Sputum Induction and Laboratory Processing
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决策分析,以最好地管理轻度失核性涂抹
N Johnson1, J Sutton, J G Thornton
1Department of Obstetrics and Gynaecology, University of Leeds, UK.
Lancet (London, England)
|July 10, 1993
概括
重复的轻度胆性宫涂抹几乎和立即的结肠镜转诊一样有效,用于预防宫癌. 这种保守的方法提供了可比的结果与潜在的成本效益,保证在查协议中仔细考虑.
科学领域:
- 妇科瘤学 妇科瘤学
- 公共卫生查 公共卫生查
- 决策分析 决策分析
背景情况:
- 宫癌查依赖于检测宫硬化症.
- 对于轻度失血性涂抹的管理决策包括重复测试或结肠镜转诊.
- 关于轻度硬化症的最佳管理策略存在不确定性.
研究的目的:
- 为了比较两种管理政策的有效性和成本,轻微的宫硬化部涂抹:重复涂抹与立即的结肠镜转诊.
- 为宫癌查计划提供基于证据的指导方针.
主要方法:
- 使用决策分析建模来比较管理政策.
- 数据是从全球文献和英国对轻度失糖性涂抹的审计中合成的.
- 预期的死亡率和成本被计算为每个政策在不同的查频率.
主要成果:
- 一项保守的重复涂抹政策,每五年进行一次查,导致每1000名妇女中有2.0例癌症病例.
- 将查减少到每三年一次,使其减少到每1000人中的1.6人,与即时结肠镜转诊率相匹配.
- 与保守策略相比,需要立即转诊进行结肠镜检查,转诊2500名女性,以预防额外的一种癌症.
结论:
- 重复的宫涂抹是一种可行的策略,几乎与轻度硬化症的立即大肠镜检查一样有效.
- 保守政策的成本效益对反复出现的异常率是敏感的.
- 在修改国家查指南之前,建议对缺血症发病率进行本地审计.
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