美国预防医学工作组建议不对普通成年人进行颈动脉狭窄筛查
发布于 2014-07-09 · 浏览 448 · IP 北京北京
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Task Force recommends against screening for carotid artery stenosis in general adult population
Annuals Of Internal Medicine: 美国预防医学工作组建议不对普通成年人进行颈动脉狭窄筛查
根据发表在《内科学年鉴》（Annals of Internal Medicine）上的建议声明，美国预防医学工作组建议不对普通成年人进行颈动脉狭窄筛查，但该建议仅适用于没有中风症状或没有中风病史的人群。在美国，中风是导致死亡和残疾的首要原因，颈动脉狭窄（斑块在颈动脉堆积导致颈动脉变狭窄）是其危险因素，但和高血压、糖尿病和高血脂症这些主要的危险因素相比，它占的比例很少。超声检查是筛查颈动脉狭窄最方便的非侵入性手段，但它的假阳性结果率较高。研究人员对56篇已发表的研究进行了系统综述，没有发现任何证据证明对普通人群进行颈动脉狭窄的筛查有益处，反而发现了低等到中等风险的危害，如伴随阳性检查结果而来的干预措施可能与中风、心肌梗塞和死亡有关。该研究发表在《内科学年鉴》（Annals of Internal Medicine）中。
The United States Preventive Services Task Force recommends against screening for asymptomatic carotid artery stenosis in the general adult population, according to a recommendation statement being published in Annals of Internal Medicine.
Stroke is a leading cause of death and disability in the United States and having carotid artery stenosis (a buildup of plaque in the carotid arteries that causes them to narrow) is a risk factor. although it accounts for a smaller number of strokes than the major risk factors hypertension, diabetes and hyperlipidemia. Ultrasonography is the most convenient and non-invasive screening test for carotid artery stenosis, but it is associated with a high rate of false positive results. Researchers conducted a systematic review of 56 published studies and found no evidence of a benefit for screening for carotid artery stenosis in the general population, but did find a small to moderate risk for harms, such as stroke, myocardial infarction, and mortality with the interventions that may follow positive screening results. The severity of harms depended on patient population, surgeon, center volume, and geographic location. This update reconfirms the Task Force's 2007 recommendation on screening for carotid artery stenosis.
The authors of an accompanying editorial write that although the data clearly support the USPSTF recommendation against population screening, these types of screenings are still offered to the public at fairs and other settings. They suggest that physician specialty society initiatives (e.g. Choosing Wisely from the American Board of Internal Medicine and High Value Care from the American College of Physicians) strengthen their messaging so that potential consumers of these services are aware that the test is unlikely to prevent them from having a stroke or lead to improvements in their health.
http://119.161.243.10/vom/info.aspx?t=0&p=&id=34552
Annuals Of Internal Medicine: 美国预防医学工作组建议不对普通成年人进行颈动脉狭窄筛查
根据发表在《内科学年鉴》（Annals of Internal Medicine）上的建议声明，美国预防医学工作组建议不对普通成年人进行颈动脉狭窄筛查，但该建议仅适用于没有中风症状或没有中风病史的人群。在美国，中风是导致死亡和残疾的首要原因，颈动脉狭窄（斑块在颈动脉堆积导致颈动脉变狭窄）是其危险因素，但和高血压、糖尿病和高血脂症这些主要的危险因素相比，它占的比例很少。超声检查是筛查颈动脉狭窄最方便的非侵入性手段，但它的假阳性结果率较高。研究人员对56篇已发表的研究进行了系统综述，没有发现任何证据证明对普通人群进行颈动脉狭窄的筛查有益处，反而发现了低等到中等风险的危害，如伴随阳性检查结果而来的干预措施可能与中风、心肌梗塞和死亡有关。该研究发表在《内科学年鉴》（Annals of Internal Medicine）中。
The United States Preventive Services Task Force recommends against screening for asymptomatic carotid artery stenosis in the general adult population, according to a recommendation statement being published in Annals of Internal Medicine.
Stroke is a leading cause of death and disability in the United States and having carotid artery stenosis (a buildup of plaque in the carotid arteries that causes them to narrow) is a risk factor. although it accounts for a smaller number of strokes than the major risk factors hypertension, diabetes and hyperlipidemia. Ultrasonography is the most convenient and non-invasive screening test for carotid artery stenosis, but it is associated with a high rate of false positive results. Researchers conducted a systematic review of 56 published studies and found no evidence of a benefit for screening for carotid artery stenosis in the general population, but did find a small to moderate risk for harms, such as stroke, myocardial infarction, and mortality with the interventions that may follow positive screening results. The severity of harms depended on patient population, surgeon, center volume, and geographic location. This update reconfirms the Task Force's 2007 recommendation on screening for carotid artery stenosis.
The authors of an accompanying editorial write that although the data clearly support the USPSTF recommendation against population screening, these types of screenings are still offered to the public at fairs and other settings. They suggest that physician specialty society initiatives (e.g. Choosing Wisely from the American Board of Internal Medicine and High Value Care from the American College of Physicians) strengthen their messaging so that potential consumers of these services are aware that the test is unlikely to prevent them from having a stroke or lead to improvements in their health.
http://119.161.243.10/vom/info.aspx?t=0&p=&id=34552
最后编辑于 2022-10-09 · 浏览 448
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