Marcello P W, Roberts P L
Department of Colon and Rectal Surgery, Lahey-Hitchcock Clinic, Burlington, MA, USA.
Surg Clin North Am. 1996 Feb;76(1):11-23. doi: 10.1016/s0039-6109(05)70418-7.
The utility of mass screening of preoperative patients has never been demonstrated for the majority of tests. Although screening patients to uncover occult disease appears logical, in reality it has resulted in excessive expenditure of our health care dollars with limited benefit. More than $30 billion is spent annually on preoperative examinations, 60% of which are unnecessary. In addition, iatrogenic injury has resulted from the further evaluation and treatment of false-positive results. A selective utilization of routine examinations can accurately supplement the clinician's evaluation, providing the patient with a complete preoperative assessment. The benefits of selective testing must be balanced against the possible omission of warranted examinations, highlighting the need for a more reliable system for test ordering.
对于大多数检测而言，术前患者群体大规模筛查的效用从未得到证实。尽管筛查患者以发现隐匿性疾病看似合乎逻辑，但实际上这导致了我们医疗保健资金的过度支出，而获益有限。每年在术前检查上花费超过300亿美元，其中60%是不必要的。此外，对假阳性结果的进一步评估和治疗导致了医源性损伤。选择性地使用常规检查可以准确地补充临床医生的评估，为患者提供完整的术前评估。选择性检测的益处必须与可能遗漏必要检查的情况相权衡，这凸显了需要一个更可靠的检查开单系统。
