Principal Author and Panel Chair, Medical University of South Carolina, Charleston, South Carolina.
Panel Vice-Chair, National Jewish Health, Denver, Colorado.
J Am Coll Radiol. 2017 May;14(5S):S160-S165. doi: 10.1016/j.jacr.2017.02.022.
Pulmonary tuberculosis remains a major cause of disease worldwide and an important public health hazard in the United States. The imaging evaluation depends to a large degree on clinical symptoms and whether active disease is suspected or a subject is at high risk for developing active disease. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
肺结核仍然是全球主要的疾病原因,也是美国重要的公共卫生危害。影像学评估在很大程度上取决于临床症状以及是否怀疑有活动性疾病,或者受检者是否有发展为活动性疾病的高风险。美国放射学院适宜性标准是针对具体临床情况的循证指南,每年由多学科专家小组进行审查。指南的制定和修订包括对同行评议期刊上的现有医学文献进行广泛分析,并应用成熟的方法学(RAND/UCLA 适宜性方法和推荐评估、制定和评价分级或 GRADE)对特定临床情况下的影像学和治疗程序的适宜性进行评分。在证据不足或存在争议的情况下,专家意见可以补充现有证据,以推荐影像学或治疗。