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《成人循证定期健康检查:实用指南》

Evidence-Based Periodic Health Examinations for Adults: A Practical Guide.

作者信息

Araujo Gabriel C, Ribeiro Caio B, Costa Maria Clara M, Evangelista Maria Luisa P, Lima Mariana F, De Paula Mateus C, Ferreira Vitoria L, Araujo Fernando Antonio Glasner da R

机构信息

Internal Medicine, Orion - Orientacao Medica, Salvador, BRA.

Internal Medicine, Universidade Federal da Bahia, Salvador, BRA.

出版信息

Cureus. 2025 Mar 3;17(3):e79963. doi: 10.7759/cureus.79963. eCollection 2025 Mar.

DOI:10.7759/cureus.79963
PMID:40177455
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11964159/
Abstract

Periodic health examinations, or annual clinical checkups, are a primary reason for seeking medical care. The objective is to identify hidden problems or diseases in their early stages and to promote behaviors that prevent or minimize the consequences of these conditions. However, the practice of conducting annual reviews with clinical, laboratory, and imaging examinations indiscriminately is not associated with outcomes that matter to the patient (such as reducing morbidity and mortality) and may result in harm, including overdiagnosis and overtreatment. The objective of the present work is to review and summarize the measures currently recommended and supported by scientific evidence from the main regulatory authorities of the United States (United States Preventive Services Task Force (USPSTF)) and Canada (Canadian Task Force on Preventive Health Care (CTFPHC)), in order to create a practical guide for evidence-based checkups.

摘要

定期健康检查,即年度临床体检,是寻求医疗护理的主要原因。其目的是在早期发现潜在问题或疾病,并促进采取预防措施或尽量减少这些疾病后果的行为。然而,不加区分地进行年度临床、实验室和影像学检查的做法与对患者重要的结果(如降低发病率和死亡率)并无关联,反而可能导致伤害,包括过度诊断和过度治疗。本研究的目的是回顾和总结目前美国主要监管机构(美国预防服务工作组(USPSTF))和加拿大(加拿大预防性医疗保健工作组(CTFPHC))推荐并得到科学证据支持的措施,以便制定一份基于证据的体检实用指南。

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Evidence-Based Periodic Health Examinations for Adults: A Practical Guide.《成人循证定期健康检查:实用指南》
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Consistency and sources of divergence in recommendations on screening with questionnaires for presently experienced health problems or symptoms: a comparison of recommendations from the Canadian Task Force on Preventive Health Care, UK National Screening Committee, and US Preventive Services Task Force.针对当前经历的健康问题或症状进行问卷调查筛查的建议中的一致性和分歧来源:加拿大预防性医疗保健工作组、英国国家筛查委员会和美国预防服务工作组建议的比较
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Screening mammography for women aged 40 to 49 years at average risk for breast cancer: an evidence-based analysis.针对40至49岁患乳腺癌平均风险女性的乳腺钼靶筛查:一项基于证据的分析。
Ont Health Technol Assess Ser. 2007;7(1):1-32. Epub 2007 Jan 1.
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No. 385-Indications for Pelvic Examination.第385号——盆腔检查的适应症
J Obstet Gynaecol Can. 2019 Aug;41(8):1221-1234. doi: 10.1016/j.jogc.2018.12.007.
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[The periodic health examination: a comparison of United States and Canadian recommendations].[定期健康检查:美国与加拿大建议之比较]
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Depression screening in primary care: why the Canadian task force on preventive health care did the right thing.初级保健中的抑郁筛查:为什么加拿大预防保健特别工作组做了正确的事情。
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Universal Depression Screening to Improve Depression Outcomes in Primary Care: Sounds Good, but Where Is the Evidence?在初级保健中进行通用抑郁症筛查以改善抑郁症治疗效果:听起来不错,但证据何在?
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Preventive care guidelines: 1991. American College of Physicians. Canadian Task Force on the Periodic Health Examination. United States Preventive Services Task Force.预防保健指南:1991年。美国医师协会。加拿大定期健康检查特别工作组。美国预防服务工作组。
Ann Intern Med. 1991 May 1;114(9):758-83. doi: 10.7326/0003-4819-114-9-758.
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Evidence-based periodic health examination of adults. Memory aid for primary care physicians.成人基于证据的定期健康检查。基层医疗医生的记忆辅助工具。
Can Fam Physician. 2006 Jan;52(1):40-7.
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Recommendations on routine screening pelvic examination: Canadian Task Force on Preventive Health Care adoption of the American College of Physicians guideline.常规盆腔检查筛查建议:加拿大预防保健工作组采用美国医师协会指南。
Can Fam Physician. 2016 Mar;62(3):211-4.

本文引用的文献

1
Screening for Osteoporosis to Prevent Fractures: US Preventive Services Task Force Recommendation Statement.骨质疏松症筛查以预防骨折:美国预防服务工作组建议声明
JAMA. 2025 Feb 11;333(6):498-508. doi: 10.1001/jama.2024.27154.
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Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement.预防社区居住老年人跌倒的干预措施:美国预防服务工作组推荐声明。
JAMA. 2024 Jul 2;332(1):51-57. doi: 10.1001/jama.2024.8481.
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Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement.乳腺癌筛查:美国预防服务工作组推荐声明。
JAMA. 2024 Jun 11;331(22):1918-1930. doi: 10.1001/jama.2024.5534.
4
Preexposure Prophylaxis to Prevent Acquisition of HIV: US Preventive Services Task Force Recommendation Statement.暴露前预防(PrEP)以预防 HIV 感染:美国预防服务工作组推荐声明。
JAMA. 2023 Aug 22;330(8):736-745. doi: 10.1001/jama.2023.14461.
5
Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement.叶酸补充剂预防神经管缺陷:美国预防服务工作组重新确认推荐声明。
JAMA. 2023 Aug 1;330(5):454-459. doi: 10.1001/jama.2023.12876.
6
Screening for Depression and Suicide Risk in Adults: US Preventive Services Task Force Recommendation Statement.成人抑郁症和自杀风险筛查:美国预防服务工作组推荐声明。
JAMA. 2023 Jun 20;329(23):2057-2067. doi: 10.1001/jama.2023.9297.
7
Screening for Anxiety Disorders in Adults: US Preventive Services Task Force Recommendation Statement.成人焦虑障碍筛查:美国预防服务工作组推荐声明。
JAMA. 2023 Jun 27;329(24):2163-2170. doi: 10.1001/jama.2023.9301.
8
Recommendations on screening for primary prevention of fragility fractures.脆性骨折一级预防筛查建议。
CMAJ. 2023 May 8;195(18):E639-E649. doi: 10.1503/cmaj.221219.
9
Screening for Latent Tuberculosis Infection in Adults: US Preventive Services Task Force Recommendation Statement.成人潜伏性结核感染的筛查:美国预防服务工作组建议声明
JAMA. 2023 May 2;329(17):1487-1494. doi: 10.1001/jama.2023.4899.
10
Screening for Syphilis Infection in Nonpregnant Adolescents and Adults: US Preventive Services Task Force Reaffirmation Recommendation Statement.梅毒感染筛查在非妊娠青少年和成年人中的应用:美国预防服务工作组重新确认推荐声明。
JAMA. 2022 Sep 27;328(12):1243-1249. doi: 10.1001/jama.2022.15322.