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我们应该不断改变白塞病的诊断标准吗?

Should we keep changing the diagnostic criteria for Behçet's disease?

作者信息

Kronborg Caroline, Mahar Patrick D, Kelly Robert

机构信息

Department of Medicine, The Alfred Hospital, Alfred Health, Melbourne, Vic., Australia.

出版信息

Dermatology. 2014;228(1):1-4. doi: 10.1159/000355481. Epub 2013 Nov 19.

Abstract

In medicine, clinical acumen is used to achieve diagnosis, guide management and prevent disease. While for some diseases, diagnosis is reached with the assistance of objective tests, many conditions rely upon the use of clinical diagnostic criteria; Behçet's disease is one such case. In order to remain clinically relevant, as knowledge of a condition changes over time so too must its diagnostic criteria. Preferably, when new criteria for a disease are conceptualised it is through sound methodology, followed by a confirmation of accuracy by way of systematic validation and response to treatment. The most recently proposed revised International Criteria for Behçet's Disease for the diagnosis of Behçet's disease have been systematically validated and should replace the use of the clinically inferior International Study Group criteria, while not displacing the role of clinical judgement. Effort should now be invested in acquiring better understanding of the pathogenesis of the disease in the hope of developing a more objective test.

摘要

在医学领域,临床敏锐度用于实现诊断、指导治疗和预防疾病。虽然对于某些疾病,诊断可借助客观检查来达成,但许多病症依赖临床诊断标准;白塞病就是这样一个例子。为了保持与临床实际相关,随着对某种病症的认识随时间变化,其诊断标准也必须相应改变。理想情况下,当为一种疾病制定新的标准时,应采用合理的方法,随后通过系统验证和对治疗的反应来确认准确性。最近提出的修订版白塞病国际诊断标准已经过系统验证,应取代临床价值较低的国际研究组标准,同时不取代临床判断的作用。现在应投入精力更好地了解该疾病的发病机制,以期开发出更客观的检测方法。

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