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克罗恩病的医师依赖性诊断延迟:是伪命题吗?

Physician-dependent diagnosis delay in Crohn's disease: A pseudo-proposition or not?

机构信息

Department of Psychology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.

Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.

出版信息

World J Gastroenterol. 2024 Oct 14;30(38):4242-4245. doi: 10.3748/wjg.v30.i38.4242.

Abstract

The challenge of diagnosis delay in inflammatory bowel disease (IBD) has emerged as a significant concern for both patients and healthcare professionals. The widely accepted notion that there is an extended time frame from the onset of symptoms to the definitive diagnosis is often attributed to the heterogeneity of IBD and the non-specificity of clinical manifestations. Specific to patients with Crohn's disease, the issue of delayed diagnosis appears to be more pronounced across different regions globally. The intricate interplay of real-world factors has led to debates regarding the primary contributors to these diagnostic delays. Drawing a comparison solely between patients and physicians and implicating the latter as the predominant influence factor may fall into a simplistic either-or logical trap that may obscure the truth. This letter, grounded in published evidence, explores areas for improvement in a forthcoming paper within the field, hoping to pinpoint the culprit behind the diagnosis delay issue for IBD patients rather than simply attributing it to so-called "physician-dependent factors". Our objective is to motivate healthcare providers and policymakers in relevant fields to reflect on strategies for addressing this problem to reduce diagnostic delays and enhance patient outcomes.

摘要

炎症性肠病(IBD)的诊断延迟问题已成为患者和医疗保健专业人员关注的焦点。人们普遍认为,从症状出现到明确诊断存在一个较长的时间框架,这主要归因于 IBD 的异质性和临床表现的非特异性。对于克罗恩病患者来说,全球不同地区的诊断延迟问题似乎更为明显。现实世界中各种因素的复杂相互作用,导致人们对导致这些诊断延迟的主要因素展开了辩论。仅仅将患者和医生进行对比,并将后者视为主要影响因素,可能会陷入一种过于简单的非此即彼的逻辑陷阱,从而掩盖了真相。本函基于已发表的证据,探讨了即将发表的一篇该领域论文中需要改进的方面,希望能够确定 IBD 患者诊断延迟问题的罪魁祸首,而不是简单地将其归因于所谓的“医生依赖因素”。我们的目的是激励相关领域的医疗保健提供者和政策制定者思考解决这一问题的策略,以减少诊断延迟并改善患者的预后。

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Diagnostic delay in inflammatory bowel diseases in a German population.炎症性肠病的德国人群中的诊断延误。
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本文引用的文献

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Diagnostic delay in inflammatory bowel diseases in a German population.炎症性肠病的德国人群中的诊断延误。
World J Gastroenterol. 2024 Aug 7;30(29):3465-3478. doi: 10.3748/wjg.v30.i29.3465.
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Diagnosis and management of inflammatory bowel disease.炎症性肠病的诊断与治疗。
J Evid Based Med. 2024 Jun;17(2):409-433. doi: 10.1111/jebm.12626. Epub 2024 Jun 27.
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Inpatient Management of Inflammatory Bowel Disease-Related Complications.炎症性肠病相关并发症的住院管理
Clin Gastroenterol Hepatol. 2020 May;18(6):1346-1355. doi: 10.1016/j.cgh.2019.12.040. Epub 2020 Jan 9.

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