Cifu Adam, Prasad Vinay
Section of General Medicine, Department of Medicine, The University of Chicago, 5841 South Maryland Avenue, MC3051, Chicago, IL, 60637, USA.
Division of Hematology Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.
J Gen Intern Med. 2016 Nov;31(11):1367-1368. doi: 10.1007/s11606-016-3761-8. Epub 2016 Jun 23.
The widespread adoption of medical practices without a firm evidence base is common and the current growing enthusiasm for atrial fibrillation screening offers a real-time example of this phenomenon. Although no randomized trials supporting the utility of screening for atrial fibrillation exist, proponents suggest that such screening should be considered. Atrial fibrillation is a common condition that is often asymptomatic. It is also a condition associated with serious morbidity, primarily resulting from stroke. We practice at a time in which the ability to detect atrial fibrillation is becoming easier and treatments are becoming less onerous. Screening for atrial fibrillation may be beneficial but there is also a reasonable likelihood that its harms will outweigh it benefits. In this article we make the case that adopting this practice prior to data from randomized controlled trial would be a mistake. If screening for atrial fibrillation is adopted without such a robust evidence base we may well later discover that this course of action was wrong.
在没有坚实证据基础的情况下广泛采用医疗实践的现象很常见，当前对房颤筛查日益增长的热情就是这一现象的一个实例。尽管尚无支持房颤筛查效用的随机试验，但支持者认为应考虑进行此类筛查。房颤是一种常见病症，通常无症状。它也是一种与严重发病相关的病症，主要由中风导致。我们所处的时代，检测房颤的能力越来越强，治疗也越来越轻松。房颤筛查可能有益，但也很有可能其危害会超过益处。在本文中，我们认为在获得随机对照试验数据之前采用这种做法将是一个错误。如果在没有如此有力证据基础的情况下采用房颤筛查，我们很可能稍后会发现这一行动方针是错误的。
