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过度诊断与过度治疗;如何应对过度医疗。

Overdiagnosis and overtreatment; how to deal with too much medicine.

作者信息

Gupta Puneeta, Gupta Meeta, Koul Neeraj

机构信息

Department of Medicine, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, J&K, India.

Department of Obstetrics and Gynaecology, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, J&K, India.

出版信息

J Family Med Prim Care. 2020 Aug 25;9(8):3815-3819. doi: 10.4103/jfmpc.jfmpc_433_20. eCollection 2020 Aug.

Abstract

The past few decades have seen medical science making rapid strides in the field of diagnostic technologies, thus making it possible to detect some conditions at a very early stage. An unwanted effect of these developments is overdiagnosis which occurs when a true abnormality is discovered, but detection of that abnormality and its treatment does not benefit the patient. Overdiagnosis is encountered as a result cancer screening, in genetic diseases and in some chronic conditions when disease definition is broadened. There is urgent need of development of evidence based decision-making tools for clinicians which will help patients understand the benefits and harms of different screening and treatment methods. And the treating physician has to play a important role to convince the patient that watchful waiting, for some of the lesions may be the best option available in some circumstances.

摘要

在过去几十年里,医学科学在诊断技术领域取得了飞速进展,从而能够在非常早期阶段检测出某些病症。这些发展带来的一个不良影响是过度诊断,即当发现真正的异常情况,但对该异常的检测及其治疗对患者并无益处时就会出现过度诊断。在癌症筛查、遗传疾病以及一些慢性病中,当疾病定义扩大时就会出现过度诊断。迫切需要为临床医生开发基于证据的决策工具,这将有助于患者理解不同筛查和治疗方法的益处与危害。而且主治医生必须发挥重要作用,使患者相信,对于某些病变,在某些情况下观察等待可能是最佳选择。

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