切换至 "中华医学电子期刊资源库"

中华临床医师杂志(电子版) ›› 2018, Vol. 12 ›› Issue (07) : 414 -416. doi: 10.3877/cma.j.issn.1674-0785.2018.07.009

所属专题: 文献

综述

如何定量过度诊疗的讨论
吴宛玲1, 王小钦1,()   
  1. 1. 200040,上海,复旦大学附属华山医院血液科,复旦大学循证医学中心
  • 收稿日期:2017-12-04 出版日期:2018-04-01
  • 通信作者: 王小钦
  • 基金资助:
    上海市第四轮公共卫生三年行动计划(15GWZK0801)

How to quantify overtreatment?

Wanling Wu1, Xiaoqin Wang1,()   

  1. 1. Department of Hematology, Huashan Hospital, Fudan University; Evidence-based Medicine Center, Fudan University, Shanghai 200040, china
  • Received:2017-12-04 Published:2018-04-01
  • Corresponding author: Xiaoqin Wang
  • About author:
    Corresponding author: Wang Xiaoqin, Email:
引用本文:

吴宛玲, 王小钦. 如何定量过度诊疗的讨论[J]. 中华临床医师杂志(电子版), 2018, 12(07): 414-416.

Wanling Wu, Xiaoqin Wang. How to quantify overtreatment?[J]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(07): 414-416.

由于医学科学迅速发展,各个医疗机构争先采用先进的医疗技术,临床过度诊疗开始成为当今医疗伦理乃至社会发展的重要问题。但如何对过度诊疗进行量化以有效地发现和控制过度诊疗行为,尚未有一个明确的答案。本文阐述了过度诊疗的定义和原因,并着重针对如何定量过度诊疗这一问题进行了讨论。

Overtreatment is a common medical phenomenon, causing many social problems. However, there is no clear answer on how to define and quantify overtreatment. In this article, we summarize the definition, current situation, and reasons of overtreatment and discuss the problems on quantifying overtreatment in order to help cope with this condition more effectively.

1
Berwick DM. Avoiding overuse—the next quality frontier [J]. Lancet, 2017, 390(10090):102-104.
2
Brownlee S, Chalkidou K, Doust J, et al. Evidence for overuse of medical services around the world [J]. Lancet, 2017, 390(10090):156-168.
3
Glasziou P, Straus S, Brownlee S, et al. Evidence for underuse of effective medical services around the world [J]. Lancet, 2017, 390(10090):169-177.
4
Kleinert S, Horton R. From universal health coverage to right care for health [J]. Lancet, 2017, 390(10090):101-102.
5
Lane R. Vikas Saini: leading activist in the Right Care Alliance [J]. The Lancet, 2017, 390(10090):117.
6
Saini V, Brownlee S, Elshaug AG, et al. Addressing overuse and underuse around the world [J]. Lancet, 2017, 390(10090):105-107.
7
Saini V, Garcia-Armesto S, Klemperer D, et al. Drivers of poor medical care [J]. Lancet, 2017, 390(10090):178-190.
8
Elshaug AG, Rosenthal MB, Lavis JN, et al. Levers for addressing medical underuse and overuse: achieving high-value health care [J]. Lancet, 2017, 390(10090):191-202.
9
滕卫平. 我国面临甲状腺癌"过度诊断"的挑战 [J]. 中华内分泌代谢杂志, 2016, 32(7):531-532.
10
Riddle DL, JiranekI WA, Hayes CW. Use of a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: a multicenter longitudinal cohort study [J]. Arthritis Rheumatol, 2014, 66(8):2134-2143.
11
Escobar A, Quintana JM, Arostegui I, et al. Development of explicit criteria for total knee replacement [J]. Int J Technol Assess Health Care, 2003, 19(1):57-70.
12
Corallo AN, Croxford R, Goodman DC, et al. A systematic review of medical practice variation in OECD countries [J]. Health Policy, 2014, 114(1):5-14.
13
Fisher ES, Bell JE, Tomek IM, et al. Trends and Regional Variation in Hip, Knee, and Shoulder Replacement [R/OL]. Lebanon (NH): Dartmouth Institute for Health Policy & Clinical Practice. (2010-4-6)[2012-7-31].

URL    
14
Kotwani A, Chaudhury RR, Holloway K. Antibiotic-prescribing practices of primary care prescribers for acute diarrhea in New Delhi, India [J]. Value Health, 2012, 15(1 Suppl):S116-119.
15
Intensive blood-glucose control with sulphonylureas or insulin compared with con-ventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group [J]. Lancet.1988, 352(9131):837-853.
16
Lipska KJ, Ross J S, Miao Y, et al. Potential overtreatment of diabetes mellitus in older adults with tight glycemic control [J]. JAMA Intern Med, 2015, 175(3):356-362.
[1] 胡欧婵, 黄仲英. 不明原因复发性流产患者的治疗研究现状与展望[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(01): 16-22.
[2] 黄明珠, 陆鹰, 何康, 王艳. 儿童肝移植受者出院后服药依从性现状调查及影响因素分析[J]. 中华移植杂志(电子版), 2023, 17(02): 112-117.
[3] 向莹莹, 伯雪, 冯欢, 李军, 褚玲玲. 基于"互联网+"精准医疗服务的发展现状[J]. 中华肺部疾病杂志(电子版), 2023, 16(01): 143-144.
[4] 关旭, 焦帅, 彭健, 姚宏亮, 王贵玉, 何庆泗, 郑阳春, 胡军红, 李太原, 康亮, 王振宁, 蔡建春, 江波, 熊治国, 马丹, 孙学军, 丁克峰, 汪泳, 周海涛, 傅传刚, 王锡山. 中国经自然腔道取标本手术41 841例开展现状分析:2022年医师调查报告[J]. 中华结直肠疾病电子杂志, 2023, 12(01): 42-49.
[5] 宋涯含, 晁洪露, 田华, 窦豆, 赵旻暐. 机器人在骨科应用相关研究的国际现状与趋势分析[J]. 中华老年骨科与康复电子杂志, 2023, 09(01): 59-64.
[6] 陈蕊, 杨洪娜, 方巍, 李鑫鑫, 李甜甜, 于孝义, 王艳雪, 李文玉. 血清与支气管肺泡灌洗液中细胞因子水平与肺内外ARDS的相关性研究[J]. 中华重症医学电子杂志, 2023, 09(03): 251-258.
[7] 赵宇, 张澍田. 内镜逆行胰胆管造影术失败原因及后续治疗有效性的单中心、真实世界研究[J]. 中华消化病与影像杂志(电子版), 2023, 13(03): 135-138.
[8] 李琼蔚, 苏怡, 卢喆, 李谦, 孙伟. 内蒙古赤峰地区高中生睡眠问题现状调查[J]. 中华临床医师杂志(电子版), 2023, 17(02): 117-124.
[9] 孙飞, 罗军, 向金波, 胡小燕. 川崎病病原菌感染及易感基因多态性的研究现状[J]. 中华临床医师杂志(电子版), 2023, 17(01): 89-92.
[10] 李帅, 殷培, 任菁菁. 医防融合背景下基层全科医师提升四级预防能力的探讨[J]. 中华临床医师杂志(电子版), 2022, 16(12): 1162-1165.
[11] 杨露, 李斌, 曾艳, 欧阳艳红, 张娜, 周明, 张华. 医警联动机制在院前急救中的应用现状及研究对策[J]. 中华临床医师杂志(电子版), 2022, 16(09): 838-841.
[12] 杨心怡, 谈宇菲, 靳月琴, 杨丽莉, 张万方, 余毅, 郑荣杰, 饶宗远, 卓慧琼, 陆龙. 广州市荔湾区居民主要慢性病流行现状及危险因素评价[J]. 中华临床实验室管理电子杂志, 2023, 11(02): 99-104.
[13] 张文刚, 柴宁莉, 令狐恩强. 经口胆道镜超级微创诊断术中不明原因胆道狭窄(IBS)病变性质鉴别新标准[J]. 中华胃肠内镜电子杂志, 2023, 10(01): 11-13.
[14] 吴洪涛, 梁娟娟, 王春平. 重大传染病疫情社区韧性内涵与外延[J]. 中华卫生应急电子杂志, 2023, 09(01): 13-19.
[15] 方杰, 秦锡虎, 汤黎明, 秦辉, 壮婷, 施宇佳. 新冠疫情常态防控模式下我院互联网医院运行及应用现状分析[J]. 中华卫生应急电子杂志, 2022, 08(06): 355-359.
阅读次数
全文


摘要