前瞻性、盲法评估氨检测在一线临床医生中实用性较低。
A Prospective, Blinded Assessment of Ammonia Testing Demonstrates Low Utility Among Front-Line Clinicians.
机构信息
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan; Division of Hospital Medicine, University of Michigan, Ann Arbor, Michigan.
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan; Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan.
出版信息
Clin Gastroenterol Hepatol. 2022 Apr;20(4):e895-e896. doi: 10.1016/j.cgh.2021.01.016. Epub 2021 Jan 13.
Although ammonia is essential to the pathophysiology of hepatic encephalopathy (HE), its levels cannot diagnose HE, do not correlate with the grade of HE, and are plagued by technical challenges. Nevertheless, ammonia levels are routinely obtained in the evaluation of hospitalized patients. We have advocated for quality improvement to limit testing. However, data are lacking regarding the reasons for, context, and perceived value of ammonia testing among ordering clinicians. Additional data are needed to optimize a quality improvement intervention aiming to curb overuse.
尽管氨对于肝性脑病（HE）的病理生理学至关重要，但它的水平不能诊断 HE，与 HE 的严重程度不相关，并且受到技术挑战的困扰。尽管如此，氨水平在住院患者的评估中仍常规获得。我们主张进行质量改进以限制检测。然而，关于订购临床医生进行氨检测的原因、背景和感知价值的数据仍然缺乏。需要更多的数据来优化旨在遏制过度使用的质量改进干预措施。
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