矮身和生长激素治疗. 一项关于医生推模式的国家研究
L Cuttler1, J B Silvers, J Singh
1Department of Pediatrics, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.
JAMA
|August 21, 1996
概括
儿科内分泌学家经常建议生长激素 (GH) 给没有GH缺乏的矮小儿童,考虑医疗,社会和感知因素. 医生对GH治疗的建议因患者个体特征和外部影响而有很大差异.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 增长激素治疗疗法 增长激素治疗
- 短期法定管理 短期法定管理
背景情况:
- 增长激素 (GH) 已被批准用于特定疾病,但在没有经典GH缺乏症 (非GHD) 的矮小儿童中使用它是有争议的.
- 专家意见在GH治疗非GHD矮身的适当性上有所不同.
研究的目的:
- 评估当前的专家意见和关于使用GH用于矮小的非GHD儿童的建议.
- 了解影响儿科内分泌学家关于这些病例GH治疗的决定的因素.
主要方法:
- 在534名专门从事矮身管理的美国儿科内分泌科医生中进行了一项全国性调查.
- 该调查实现了81.3%的响应率,分析了专家在各种临床场景中对GH的治疗建议.
主要成果:
- 医生报告说,42%接受GH治疗的患者患有非GHD疾病.
- 在短非GHD儿童中,对GH的建议因儿童的成长,家庭的愿望,成本和医生的信念而有显著差异 (从1%到74%) .
- 医学,社会和感知因素独立地影响了GH推决策.
结论:
- 许多儿科内分泌学家支持为选定的非GHD儿童提供GH治疗,超出目前FDA批准的用途.
- GH处方决定涉及临床数据,患者/家庭因素和医生的看法的复杂相互作用.
- 未来的GH利用将受到临床试验数据,患者/家庭偏好,成本和医生的观点的影响.
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