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基层医疗中的即时检测:是希望还是炒作?

Point-of-care tests in general practice: hope or hype?

机构信息

Maastricht University, Department of General Practice, CAPHRI School for Public Health and Primary Care , Maastricht , the Netherlands.

出版信息

Eur J Gen Pract. 2013 Dec;19(4):251-6. doi: 10.3109/13814788.2013.800041. Epub 2013 Aug 22.

Abstract

Point-of-care tests are biomedical tests on patients' specimens like blood, saliva, urine or faeces, which can be used near the patient, without interference of a laboratory. The use of these tests, many of which have been recently developed, is increasing in general practice, where they add to the GP's set of diagnostic instruments. The question is, however, whether they always contribute to an effective and high-quality diagnostic process by GPs. We present a set of criteria that can be used by guideline developers, regional primary care organizations and individual GPs to evaluate a new point-of-care test in a practice setting. These criteria do not relate only to their use and quality. A point-of-care test needs to be evaluated in the right population and for the right indications, and GPs then need to use them for the indications for which they were evaluated. Expanding the range of indications can lead to an increase in false-positive and false-negative test results.

摘要

即时检测是对患者的血液、唾液、尿液或粪便等标本进行的生物医学检测,可以在患者身边进行,无需实验室干预。这些检测的使用越来越多,其中许多是最近开发的,它们增加了全科医生的诊断工具集。然而,问题是它们是否总能通过全科医生的诊断过程来提高诊断的有效性和质量。我们提出了一套标准,指南制定者、区域初级保健组织和个体全科医生可以用来在实践中评估新的即时检测。这些标准不仅与使用和质量有关。即时检测需要在正确的人群和正确的适应证中进行评估,然后全科医生需要根据评估的适应证使用它们。扩大适应证范围可能会导致假阳性和假阴性检测结果的增加。

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