Schneede J
Department for Pharmacology, University of Bergen, Norway.
Scand J Clin Lab Invest. 2003;63(5):369-75. doi: 10.1080/00365510310002068.
There is currently no consensus on how to define, diagnose and treat vitamin B12 deficiency. This is partly due to insufficient and non-uniform study design. It is essential to come to a harmonization of rational study designs. In order to evaluate new tests for the diagnosis of vitamin B12 deficiency, it is important that independent and unequivocal criteria for a clear-cut definition of the disease are used. Furthermore, it is crucial to have a mutual understanding on the progression of the disease, how fast the different symptoms may develop and on the expected time frame of treatment and evaluation of response. The kind and intensity of treatment must also be agreed upon. The present article overviews the potential strategies of how to define and diagnose vitamin B12 deficiency and on follow-up of treatment response. Finally, based on these considerations, the prerequisites of a cost-utility analysis of guidelines for diagnosing vitamin B12 deficiency are discussed.
目前，关于如何定义、诊断和治疗维生素B12缺乏症尚无共识。部分原因是研究设计不足且不统一。统一合理的研究设计至关重要。为了评估诊断维生素B12缺乏症的新检测方法，使用明确的、独立且毫不含糊的疾病定义标准非常重要。此外，对于疾病的进展、不同症状可能发展的速度以及治疗和反应评估的预期时间框架达成相互理解也至关重要。治疗的种类和强度也必须达成一致。本文概述了定义和诊断维生素B12缺乏症以及治疗反应随访的潜在策略。最后，基于这些考虑，讨论了维生素B12缺乏症诊断指南成本效用分析的先决条件。
