Bidoli Ettore, Villalta Danilo, Battistin M, Bidoli E, Cammarota A, Ciccone M, Fedato R, Lodi B, Marchesini F, Molaro G, Ostardo E, Rellini G, Sartori R, Schinella D
Biostatistics and Epidemiology Unit, Centro di Riferimento Oncologico, via Pedemontana Occidentale, 33081 Aviano (PN), Italy.
Autoimmun Rev. 2007 Jun;6(6):354-8. doi: 10.1016/j.autrev.2007.01.008. Epub 2007 Jan 31.
Arrays are one of the technologies able to detect autoantibodies by measuring simultaneously many thousands of markers from a unique biological sample. The main purpose of a diagnostic test is making an early and accurate diagnosis. From a statistical point of view, multiple testing increases the probability of false positive and false negative results. Some correction methods are available to account for this problem for instance family-wise error rate or false discovery rate. From an ethical point of view, the decision to accept or decline a test not requested has to be made autonomously. Some people may seek clarification about tests and implications of their choices. A scarcity of proven measures to reduce mortality has to be considered too. Reasons may also include avoidance of psychological harm or anxiety. Moreover, protection of confidentiality and privacy has to be respected. In conclusion, the fact that testing is optional and that surveillance advice can be offered on the basis of risk alone without a test should be discussed in the consultation. The implication of a positive test result should be discussed to make a decision about the degree to which early treatment of the condition is better than late (or no) treatment.
阵列是能够通过同时测量来自单个生物样本的数千种标志物来检测自身抗体的技术之一。诊断测试的主要目的是进行早期准确的诊断。从统计学角度来看，多次测试会增加假阳性和假阴性结果的概率。有一些校正方法可用于解决这个问题，例如家族性错误率或错误发现率。从伦理角度来看，对于接受或拒绝非请求性检测的决定必须自主做出。有些人可能会寻求关于检测及其选择影响的澄清。还必须考虑缺乏经证实的降低死亡率的措施。原因还可能包括避免心理伤害或焦虑。此外，必须尊重保密性和隐私保护。总之，在咨询中应讨论检测是可选的这一事实，以及仅基于风险而不进行检测就可以提供监测建议。应讨论阳性检测结果的影响，以便决定该疾病的早期治疗在何种程度上优于晚期（或不治疗）。
