Marton K I, Rudd P, Sox H C
West J Med. 1980 Jul;133(1):19-25.
The usefulness of a clinical examination was compared with several other procedures (ultrasonography, pancreatic function tests, endoscopic retrograde cholangiopancreatography and angiography) for diagnosing pancreatic cancer. We used a simplified form of decision analysis to show the effects of different strategies on direct diagnostic costs, missed diagnoses and false-positive diagnoses. Our analysis indicates that existing laboratory tests are either too non-specific or too invasive to be used successfully as screening tests for pancreatic cancer. To decrease the number of unnecessary laparotomies due to false-positive test findings, patients should have a high probability of pancreatic cancer, based on clinical criteria, before further testing is carried out. In fact, existing clinical criteria are both sensitive and specific for pancreatic cancer.
将临床检查与其他几种检查方法（超声检查、胰腺功能测试、内镜逆行胰胆管造影和血管造影）用于诊断胰腺癌的效用进行了比较。我们采用了一种简化的决策分析形式，以显示不同策略对直接诊断成本、漏诊和假阳性诊断的影响。我们的分析表明，现有的实验室检查要么特异性不强，要么侵入性过大，无法成功用作胰腺癌的筛查检查。为了减少因检查结果假阳性导致的不必要剖腹手术数量，在进行进一步检查之前，根据临床标准，患者应具有较高的患胰腺癌概率。事实上，现有的临床标准对胰腺癌既敏感又具有特异性。
