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慢性阻塞性肺疾病筛查:美国预防服务工作组重新确认推荐声明。

Screening for Chronic Obstructive Pulmonary Disease: US Preventive Services Task Force Reaffirmation Recommendation Statement.

机构信息

University of California, Los Angeles.

Harvard Medical School, Boston, Massachusetts.

出版信息

JAMA. 2022 May 10;327(18):1806-1811. doi: 10.1001/jama.2022.5692.

Abstract

IMPORTANCE

Chronic obstructive pulmonary disease (COPD) is an irreversible reduction of airflow in the lungs. Progression to severe disease can prevent participation in normal activities because of deterioration of lung function. In 2020 it was estimated that approximately 6% of US adults had been diagnosed with COPD. Chronic lower respiratory disease, composed mainly of COPD, is the sixth leading cause of death in the US.

OBJECTIVE

To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update that focused on targeted key questions for benefits and harms of screening for COPD in asymptomatic adults and treatment in screen-detected or screen-relevant adults.

POPULATION

Asymptomatic adults who do not recognize or report respiratory symptoms.

EVIDENCE ASSESSMENT

Using a reaffirmation process, the USPSTF concludes with moderate certainty that screening for COPD in asymptomatic adults has no net benefit.

RECOMMENDATION

The USPSTF recommends against screening for COPD in asymptomatic adults. (D recommendation).

摘要

重要性

慢性阻塞性肺疾病(COPD)是一种肺部气流不可逆性减少的疾病。疾病的进展会导致肺功能恶化,从而使患者无法参与正常活动。据估计,2020 年美国约有 6%的成年人被诊断患有 COPD。慢性下呼吸道疾病主要由 COPD 组成,是美国第六大致死原因。

目的

为了更新其 2016 年的建议,美国预防服务工作组(USPSTF)委托进行了一次重新确认证据更新,重点关注无症状成年人筛查 COPD 的获益和危害以及筛查发现或与筛查相关的成年人治疗的针对性关键问题。

人群

无症状且不识别或报告呼吸症状的成年人。

证据评估

使用重新确认过程,USPSTF 得出结论,对无症状成年人进行 COPD 筛查没有净收益,这一结论有中等确定性。

建议

USPSTF 建议不对无症状成年人进行 COPD 筛查。(D 级推荐)。

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