Nothacker Monika, Langer Thomas, Weinbrenner Susanne
Ärztliches Zentrum für Qualität in der Medizin, Berlin.
Z Evid Fortbild Qual Gesundhwes. 2010;104(7):554-62. doi: 10.1016/j.zefq.2010.08.003. Epub 2010 Oct 8.
Within the context of the development of evidence-based oncology guidelines, the Agency for Quality in Medicine undertook evidence reviews for diagnostic imaging procedures. Systematic searches retrieved no randomised controlled trials, but only cohort studies and case series of mostly moderate quality. The identified studies provided only a restricted basis for the guideline recommendations as their validity was limited and only outcomes of diagnostic accuracy were examined. However, decision criteria for recommending diagnostic strategies significantly comprise judgements about required resources and availability of diagnostic imaging procedures. These criteria as well as patient out-comes were mostly implicit and should be explicated in future. In order to increase the relevance of evidence reviews for oncological diagnosis, high quality studies which examine resources and patient-centred outcomes for diagnostic strategies are required.
在循证肿瘤学指南的制定背景下,医学质量机构对诊断成像程序进行了证据审查。系统检索未找到随机对照试验,仅找到队列研究和大多质量中等的病例系列。已识别的研究仅为指南建议提供了有限的依据,因为其有效性有限且仅检查了诊断准确性的结果。然而,推荐诊断策略的决策标准很大程度上包括对所需资源和诊断成像程序可用性的判断。这些标准以及患者结果大多是隐含的,未来应予以阐明。为了提高证据审查对肿瘤诊断的相关性,需要高质量的研究来检查诊断策略的资源和以患者为中心的结果。