Medical history taking

医疗史
  • 文章类型: Journal Article
    背景:模拟是一种在医疗保健教育中越来越多地使用的技术,它提供了评估护理熟练程度的机会。使用有效和可靠的工具被认为是可靠评估的基础,然而,研究生护士基于能力的健康评估课程可以成为衡量熟练程度的简化者。
    目标:具体的复习问题是:在基于模拟的教育中,评估研究生护理学生获得健康史和患者评估表现的能力的标准是什么?
    方法:本综述纳入了11项研究。论文通过JoannaBriggs研究所准实验研究清单进行了严格评估。布卢姆的分类法被用来构建这篇叙述性评论。
    结果:七篇论文通过问卷评估认知,两篇论文使用李克特量表来确定自我感知知识。六篇论文用行为清单评估了精神运动技能。在测试情感技能时,应用的多样性被纳入研究。三篇论文使用了李克特量表来评估准备情况,六篇论文使用Likert量表来评估自信心,一篇论文使用Likert量表来评估自主性。三篇论文使用清单来评估专业水平。四篇论文使用了教职员工/标准化的患者反馈。
    结论:还原论评估工具在评估能力时会造成障碍。仿真中评估仪器的有效性和可靠性有限,以及情感技能评估缺乏标准化,对仿真研究提出了挑战。情感技能包括态度,行为和沟通能力,由于其主观性,这对标准化评估构成了重大挑战。对仿真文献的回顾强调了情感领域评估中缺乏鲁棒性。本文提出模拟评估工具应包括情感领域熟练程度的标准化,例如:适应患者的认知功能,解释和综合相关信息的能力,证明临床判断的能力,准备采取行动,对专业局限性和教师/标准化模拟患者反馈的认识。将情感领域纳入标准化评估工具对于确保对模拟进行全面评估非常重要,特别是在健康史和身体评估熟练程度的发展中。在模拟评估期间注意Blooms分类法中的所有领域,有可能为患者护理环境更好地准备专业人员。
    BACKGROUND: Simulation is a technique being used increasingly in healthcare education which offers opportunities to evaluate nursing proficiencies. The use of valid and reliable instruments is recognised as the foundation for a robust assessment, however competency-based health assessment courses for graduate nurses can consequently become reductionist in measuring proficiencies.
    OBJECTIVE: The specific review question was: In simulation-based education, what are the criteria that evaluate graduate nursing student\'s competence in obtaining a health history and performance of patient assessment?
    METHODS: Eleven studies were included in the review. Papers were critically appraised with The Joanna Briggs Institute quasi-experimental studies checklist. Bloom\'s taxonomy was used to structure this narrative review.
    RESULTS: Seven papers evaluated cognition through questionnaires and two papers used a Likert-scale to determine self-perceived knowledge. Six papers evaluated psychomotor skills with a behavioural checklist. Diversity of application was factored into the studies when testing affective skills. Three papers used Likert-scales to evaluate preparedness, six papers used Likert-scales to evaluate self-confidence and one used a Likert-scale to evaluate autonomy. Three papers used a checklist to evaluate professionalism. Four papers used faculty member/ standardised patient feedback.
    CONCLUSIONS: Reductionist evaluation instruments create a barrier when evaluating competency. The limited validity and reliability of assessment instruments in simulation, as well as the lack of standardisation of affective skills assessment, presents a challenge in simulation research. Affective skills encompass attitudes, behaviours and communication abilities, which pose a significant challenge for standardised assessments due to their subjective nature. This review of the simulation literature highlights a lack of robustness in the evaluation of the affective domain. This paper proposes that simulation assessment instruments should include the standardisation of affective domain proficiencies such as: adaptation to patients\' cognitive function, ability to interpret and synthesise relevant information, ability to demonstrate clinical judgement, readiness to act, recognition of professional limitations and faculty/standardised-simulated patient feedback. The incorporation of the affective domain in standardised assessment instruments is important to ensure comprehensive assessment of simulation particularly in the development of health history and physical assessment proficiencies. Attention to all of the domains in Blooms taxonomy during simulation assessment has the potential to better prepare professionals for the patient care setting.
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  • 文章类型: Journal Article
    结论:为了加快文章的发表,AJHP在接受后尽快在线发布手稿。接受的手稿经过同行评审和复制编辑,但在技术格式化和作者打样之前在线发布。这些手稿不是记录的最终版本,将在以后替换为最终文章(按照AJHP样式格式化并由作者证明)。
    目的:全面的用药史有助于安全治疗。许多旨在改善用药史的方法需要大量的人力资源。为了设计一个高效的流程,提供高质量的用药历史,需要考虑给定环境的个人要求和资源。我们旨在概述现有的用药史方法及其在不同环境中的表现,以可能支持选择适当的程序。
    方法:我们检索了3个文献数据库(PubMed/MEDLINE,CINAHL,PsycINFO)forpublicationsonapproachestomedicationhistorytakingandanalyzedthemwithregardtotheirkeycomponentsaswellasthesetting,患者群体,评估结果,和功效。
    结果:总计,纳入并分析了65篇出版物。大多数报告的方法依赖于敬业的工作人员的参与(n=43),其次是面向过程的干预措施(例如,清单;n=15)和信息技术(IT)指导的干预(n=11)。在每个研究中描述了6(2.9)个结果的平均值(SD)。在所有研究中,有89%的研究报告了用药差异,然而,使用了大约75种不同的描述,很难比较研究结果。只有11项研究采用了样本量计算和统计检验。其中,10报道了他们各自的干预对用药史质量的积极影响。
    结论:大多数方法侧重于药房工作人员,这与相当大的成本和资源有关。因此,基于IT的方法和患者参与应作为具有成本效益的替代方案进行研究,并在相同的环境中测试其优越性。需要报告准则和标准化方法来提高此类研究的可比性。
    OBJECTIVE: A comprehensive medication history can contribute to safe therapy. Many approaches aiming to improve medication history taking require significant human resources. To design an efficient process that delivers high-quality medication histories, the individual requirements and resources of a given setting need to be considered. We aimed to provide an overview of existing approaches to medication history taking and their performance in different settings to potentially support the selection of an appropriate procedure.
    METHODS: We searched 3 literature databases (PubMed/MEDLINE, CINAHL, PsycINFO) for publications on approaches to medication history taking and analyzed them with regard to their key components as well as the setting, patient population, assessed outcomes, and efficacy.
    RESULTS: In total, 65 publications were included and analyzed. The majority of the reported approaches relied on involvement of dedicated staff (n = 43), followed by process-oriented interventions (eg, checklists; n = 15) and information technology (IT)-guided interventions (n = 11). A mean (SD) of 6 (2.9) outcomes were described in each study. Medication discrepancies were reported in 89% of all studies, yet about 75 different descriptions of this outcome were used, making it difficult to compare study results. Only 11 studies applied a sample size calculation and statistical tests. Of those, 10 reported a positive effect of their respective intervention on the quality of medication histories.
    CONCLUSIONS: Most approaches focused on pharmacy staff, which are associated with considerable cost and resources. Therefore, IT-based approaches and patient engagement should be investigated as cost-effective alternatives and tested for superiority in the same setting. Reporting guidelines and standardized methodology are needed to improve the comparability of such studies.
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  • 文章类型: Journal Article
    背景:已显示各种医疗状况和用于治疗它们的药物会阻碍或使牙科植入物手术复杂化。仔细监测全身性疾病患者的医疗状况和潜在的术后并发症至关重要,尤其是老年患者,将可能出现的健康并发症的风险降至最低。
    目的:本研究的目的是回顾有关全身性疾病患者种植牙的可行性的现有证据,并提供实用建议,以在相应的患者人群中达到最佳效果。
    方法:我们的研究信息是使用PubMed的数据汇编的,Scopus,WebofScience和GoogleScholar数据库,并分别搜索了我们工作中包含的每种全身性疾病,直到2023年10月。还进行了额外的手动搜索以增加搜索灵敏度。只包括英文出版物,并根据标题进行评估,摘要和全文。
    结果:总计,发现了6784项研究。检查重复项和全文可用性后,筛选纳入标准并手动搜索参考名单,本研究仍有570篇文章有待考虑。
    结论:在治疗患有全身性疾病的患者时,成本效益分析应考虑患者的生活质量和预期寿命.牙科植入物的成功很大程度上取决于确保适当的维持治疗,理想的口腔卫生标准,不吸烟,避免其他危险因素。在全身性疾病的情况下,牙科植入物的适应症和禁忌症尚待进一步了解;需要进行更广泛和核心的研究,以建立指南基础。
    BACKGROUND: Various medical conditions and the drugs used to treat them have been shown to impede or complicate dental implant surgery. It is crucial to carefully monitor the medical status and potential post-operative complications of patients with systemic diseases, particularly elderly patients, to minimize the risk of health complications that may arise.
    OBJECTIVE: The purpose of this study was to review the existing evidence on the viability of dental implants in patients with systemic diseases and to provide practical recommendations to achieve the best possible results in the corresponding patient population.
    METHODS: The information for our study was compiled using data from PubMed, Scopus, Web of Science and Google Scholar databases and searched separately for each systemic disease included in our work until October 2023. An additional manual search was also performed to increase the search sensitivity. Only English-language publications were included and assessed according to titles, abstracts and full texts.
    RESULTS: In total, 6784 studies were found. After checking for duplicates and full-text availability, screening for the inclusion criteria and manually searching reference lists, 570 articles remained to be considered in this study.
    CONCLUSIONS: In treating patients with systemic conditions, the cost-benefit analysis should consider the patient\'s quality of life and expected lifespan. The success of dental implants depends heavily on ensuring appropriate maintenance therapy, ideal oral hygiene standards, no smoking and avoiding other risk factors. Indications and contraindications for dental implants in cases of systemic diseases are yet to be more understood; broader and hardcore research needs to be done for a guideline foundation.
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  • 文章类型: Review
    目的:本研究旨在评估伊斯坦布尔三级神经肌肉中心142名患者的肌萎缩蛋白病中癫痫的患病率和特征。土耳其。
    方法:我们记录了癫痫发作时的年龄,癫痫发作类型,家族史,高热惊厥史,治疗,和脑电图结果。癫痫根据最新的国际抗癫痫联盟(ILAE)分类进行分类。
    结果:在142例DMD患者中,8例癫痫发作(5.6%)。患者的中位年龄为11岁(8.0-15.2)。首次出现DMD症状的中位年龄为24个月(16.5-37.5)。所有癫痫发作均与全身性强直-阵挛性癫痫发作一致。三名患者目前正在服用抗癫痫药物。
    结论:我们的研究中癫痫的患病率(5.6%)超过了普通儿科人群(0.5-1%)。然而,肌营养不良症患儿的高热惊厥频率与一般人群相似。
    OBJECTIVE: This study aimed to assess the prevalence and characteristics of epilepsy in dystrophinopathies within a cohort of 142 patients at a tertiary neuromuscular center in Istanbul, Turkey.
    METHODS: We recorded the age at seizure onset, seizure type, family history, history of febrile seizures, treatment, and EEG results. Epilepsy was classified according to the latest International League Against Epilepsy (ILAE) classification.
    RESULTS: Of the 142 DMD patients, 8 experienced epileptic seizures (5.6 %). The median age of the patients was 11 years (8.0-15.2). The median age for the first DMD symptoms was 24 months (16.5-37.5). All seizures were consistent with generalized tonic-clonic seizures. Three patients are currently on anti-seizure medication.
    CONCLUSIONS: The prevalence of epilepsy in our study (5.6 %) exceeds that of the general pediatric population (0.5-1 %). However, the frequency of febrile seizures in children with dystrophinopathy is similar to that of the general population.
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  • 文章类型: Journal Article
    UNASSIGNED:椎基底动脉血管病变和上颈椎韧带不稳定可能禁止使用颈椎手法治疗。我们检查了物理治疗师对这些疾病的筛查记录,并假设筛查在特定风险因素和使用手动治疗时会更常见。
    UNASSIGNED:该图表回顾包括2015-2021年期间接受门诊物理治疗的颈部疼痛的成年人。排除包括年龄<18岁和颈椎手术史。人口统计,椎基底动脉和上颈椎韧带不稳定的筛查问题和检查测试,危险因素(即高血压,鞭打),并使用手动疗法进行提取。
    UNASSIGNED:纳入260名患者(平均年龄±标准差59.6±16.2岁,70.8%女性)。物理治疗师很少进行椎基底动脉和上颈椎韧带不稳定测试(每个<14%)。筛查问题通常更常见(例如头痛,视力障碍;每次>13%)。考虑到高血压的存在,任何筛查方法的频率都没有显着差异,鞭打,或使用手动治疗(每个p>0.05)。
    未经批准:在本研究中,物理治疗师很少记录的表现椎基底动脉或上颈椎韧带不稳定筛查成人颈部疼痛,即使存在危险因素或之前的手动治疗。进一步的研究应该证实这些发现,并探索使用/避免筛查的原因。
    Vertebrobasilar vascular pathology and upper cervical ligament instability may contraindicate the use of cervical manual therapy. We examined physical therapists\' documentation of screening for these conditions and hypothesized screening would be more common with specific risk factors and when using manual therapy.
    This chart review included adults with neck pain presenting for outpatient physical therapy from 2015-2021. Exclusions were age<18 and history of cervical spine surgery. Demographics, vertebrobasilar and upper cervical ligament instability screening questions and examination tests, risk factors (i.e. hypertension, whiplash), and use of manual therapy were extracted.
    260 patients were included (mean age ± standard deviation 59.6 ± 16.2 years, 70.8% female). Physical therapists infrequently administered vertebrobasilar and upper cervical ligament instability tests (each<14%). Screening questions were generally more common (e.g. headache, visual disturbances; each>13%). There was no significant difference in any frequency of screening method given the presence of hypertension, whiplash, or use of manual therapy (p > .05 for each).
    In the present study, physical therapists infrequently documented performance of vertebrobasilar or upper cervical ligament instability screening for adults with neck pain, even in the presence of risk factors or preceding manual therapy. Further research should corroborate these findings and explore reasons for use/avoidance of screening.
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  • 文章类型: Systematic Review
    目的:讨论如何为具有手术矫正肛门直肠畸形(ARM)既往病史的女性阴道分娩提供建议。这篇综述的目的是评估和回顾这些女性阴道分娩后报道的产科并发症和结局。
    方法:从开始到2022年7月25日在PubMed进行了系统搜索,Embase.com和ClarivateAnalytics/WebofScienceCoreCollection,反向引用跟踪。
    UNASSIGNED:除编辑性评论或邀请性评论外,所有报道有手术矫正肛门直肠畸形病史并经阴道分娩的妇女的关注结局的文章均纳入其中。筛选,数据提取和偏倚风险评估由两名作者独立完成,并由第三和第四审核员在存在分歧的情况下进行.质量评估工具取决于文章的类型。由于预期存在低质量证据,因此未进行荟萃分析。
    结果:在2377篇筛选的文章中,只有5篇符合纳入条件,共有8名女性13次尝试阴道分娩。报告了三例患者的并发症:两名患者的阴道分娩失败,需要紧急剖宫产,还有一个病人的阴道撕裂.
    结论:缺乏关于有手术矫正肛门直肠畸形病史的女性阴道分娩后结局和并发症的高质量证据。因此,根据本系统评价,无法就其安全性提出正式建议.未来的研究对于解决这个问题至关重要。
    背景:CRD42020201390.日期:2020年7月28日。
    OBJECTIVE: Discussion remains on how to advise women with a past medical history of surgically corrected anorectal malformations (ARMs) regarding vaginal delivery. The aim of this review is to evaluate and review the reported obstetrical complications and outcomes after vaginal delivery for these women.
    METHODS: A systematic search was performed from inception up to 25 July 2022 in PubMed, Embase.com and Clarivate Analytics/Web of Science Core Collection, with backward citation tracking.
    UNASSIGNED: All articles reported on the outcomes of interest in women with a past medical history of surgically corrected anorectal malformation and had a vaginal delivery were included with the exception of editorial comments or invitational commentaries. Screening, data extraction and risk of bias assessment was done by two authors independently with a third and fourth reviewer in case of disagreement. Tool for Quality assessment depended on the type of article. As low quality evidence was expected no meta-analysis was performed.
    RESULTS: Only five of the 2377 articles screened were eligible for inclusion with a total of 13 attempted vaginal deliveries in eight women. In three patients complications were reported: failed vaginal delivery requiring urgent cesarean section in two patients, and vaginal tearing in one patient.
    CONCLUSIONS: High quality evidence regarding outcomes and complications after vaginal delivery in women with a history of surgically corrected anorectal malformation is lacking. Therefore, based upon this systematic review no formal recommendation can be formulated regarding its safety. Future studies are essential to address this problem.
    BACKGROUND: CRD42020201390. Date: 28-07-2020s.
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  • 文章类型: Journal Article
    许多医疗条件,也许其中80%,可以通过全面的现病史(HPI)来诊断。然而,在临床环境中,中断和时间压力等情境因素可能导致与患者的互动简短且支离破碎.提高临床医生收集全面HPI并最大限度地提高护理效率和质量的能力的一个解决方案是在临床医生进行面对面评估之前使用数字工具获得HPI。
    我们的目标是识别和表征旨在直接从患者或护理人员那里获得HPI的数字工具,并在面对面接触之前将这些信息呈现给临床医生。我们还试图描述这些工具测试中报告的结果,尤其是那些与可用性相关的,效率,和护理质量。
    我们在以下数据库中使用预定义的搜索词进行了范围审查:MEDLINE,CINAHL,PsycINFO,WebofScience,Embase,IEEEXplore数字图书馆,ACM数字图书馆,和ProQuest学位论文和论文全球。两名审稿人筛选了标题和摘要的相关性,对符合纳入标准的文章进行全文审查,并使用堆排序程序来识别工具的区别特征。描述工具的信息主要是从确定的同行评审来源获得的;此外,补充信息是从工具网站以及通过与工具创建者的直接通信获得的。
    我们确定了18种符合纳入标准的工具。在这18个工具中,14(78%)主要使用封闭式和多项选择题,1(6%)使用自由文本输入,3人(17%)使用会话(聊天机器人)风格。超过一半(10/18,56%)的工具是针对特定患者亚群定制的;其余(8/18,44%)的工具没有指定目标亚群。在18个工具中,7(39%)包括多语言支持,12人(67%)有能力直接将数据传输到电子健康记录中。对与可用性相关的各种结果度量报告的工具的研究,效率,和护理质量。
    我们确定的HPI工具(N=18)的目的和功能差异很大。关于应如何收集或向临床医生提供患者生成的信息尚未达成共识。现有的工具经历了不一致的测试水平,在评估中使用了各种各样不同的结果衡量标准,包括一些与可用性相关的,效率,和护理质量。人们对使用数字工具从患者那里获得HPI有很大的兴趣,但是测量的结果不一致。未来的研究应该集中在使用HPI工具是否可以改善患者体验和健康结果。尽管只要监测患者安全,也可以使用替代终点.
    Many medical conditions, perhaps 80% of them, can be diagnosed by taking a thorough history of present illness (HPI). However, in the clinical setting, situational factors such as interruptions and time pressure may cause interactions with patients to be brief and fragmented. One solution for improving clinicians\' ability to collect a thorough HPI and maximize efficiency and quality of care could be to use a digital tool to obtain the HPI before face-to-face evaluation by a clinician.
    Our objective was to identify and characterize digital tools that have been designed to obtain the HPI directly from patients or caregivers and present this information to clinicians before a face-to-face encounter. We also sought to describe outcomes reported in testing of these tools, especially those related to usability, efficiency, and quality of care.
    We conducted a scoping review using predefined search terms in the following databases: MEDLINE, CINAHL, PsycINFO, Web of Science, Embase, IEEE Xplore Digital Library, ACM Digital Library, and ProQuest Dissertations & Theses Global. Two reviewers screened titles and abstracts for relevance, performed full-text reviews of articles meeting the inclusion criteria, and used a pile-sorting procedure to identify distinguishing characteristics of the tools. Information describing the tools was primarily obtained from identified peer-reviewed sources; in addition, supplementary information was obtained from tool websites and through direct communications with tool creators.
    We identified 18 tools meeting the inclusion criteria. Of these 18 tools, 14 (78%) used primarily closed-ended and multiple-choice questions, 1 (6%) used free-text input, and 3 (17%) used conversational (chatbot) style. More than half (10/18, 56%) of the tools were tailored to specific patient subpopulations; the remaining (8/18, 44%) tools did not specify a target subpopulation. Of the 18 tools, 7 (39%) included multilingual support, and 12 (67%) had the capability to transfer data directly into the electronic health record. Studies of the tools reported on various outcome measures related to usability, efficiency, and quality of care.
    The HPI tools we identified (N=18) varied greatly in their purpose and functionality. There was no consensus on how patient-generated information should be collected or presented to clinicians. Existing tools have undergone inconsistent levels of testing, with a wide variety of different outcome measures used in evaluation, including some related to usability, efficiency, and quality of care. There is substantial interest in using digital tools to obtain the HPI from patients, but the outcomes measured have been inconsistent. Future research should focus on whether using HPI tools can lead to improved patient experience and health outcomes, although surrogate end points could instead be used so long as patient safety is monitored.
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  • 文章类型: Review
    了解患者的高血压(HTN)症状可以帮助医疗保健专业人员了解个人,文化,和行为反应,并提高诊断准确性,以优化治疗。这篇综述的目的是评估和综合目前探索HTN症状的文献。
    搜索的数据库包括MEDLINE(PubMed),CINAHL(EBSCO),Scopus,和WebofScience从2010年1月到2022年1月。搜索遵循系统评论和荟萃分析指南的首选报告项目。McMaster批判性审查表格用于确定定性和定量文章的质量。数据的合成由JoannaBriggs研究所的融合综合方法指导混合研究系统审查。
    总共,包括41篇文章,9项定性研究和32项定量研究。文章的质量各不相同。症状包括通常报告的症状和一些不太普遍的症状,包括一些报告没有症状。影响症状的因素包括文化,信仰,社会心理因素,和知识。我们还发现,症状和行为之间可能存在双向关系,可能导致自我管理。
    HTN很常见,症状也很常见。HTN管理与多种因素有关。最初诊断后,许多个体的症状仍在继续。初步诊断后评估症状可能有助于最佳管理和满足血压指南。
    Understanding patients\' hypertension (HTN) symptoms can assist healthcare professionals\' awareness of individual, cultural, and behavioral responses and improve diagnostic accuracy to optimize treatment. The purpose of this review was to evaluate and synthesize current literature exploring HTN symptoms.
    Databases searched included MEDLINE (PubMed), CINAHL (EBSCO), Scopus, and Web of Science from January 2010 to January 2022. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The McMaster critical review forms were used to determine the quality of both qualitative and quantitative articles. Synthesis of the data was guided by the Joanna Briggs Institute Convergent Integrated Approach to Mixed Study Systematic Reviews.
    In total, 41 articles were included, nine qualitative studies and 32 quantitative. The quality of the articles varied. Symptoms included commonly reported symptoms and some less prevalent, including some reporting absence of symptoms. Factors that affected symptoms included culture, beliefs, psychosocial factors, and knowledge. We also found that there may be a bidirectional relationship between symptoms and behaviors that may lead to self-management.
    HTN is common and symptoms are frequently reported. HTN management is related to multiple factors. Symptoms continue in a number of individuals after initial diagnosis. Evaluating symptoms after initial diagnosis may help to optimally manage and meet blood pressure guidelines.
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  • 文章类型: Journal Article
    这项研究旨在绘制易感口腔鳞状细胞癌(OSCC)发病的系统性改变。本综述是根据系统评价和荟萃分析的首选报告项目进行的。五个数据库被用于访问(1)OSCC在全身疾病患者中同时发生的报告,(2)OSCC在这些患者中的患病率,(3)临床病理特征。来自全球100多万患者的数据显示,范可尼的贫血,着色性干皮病,先天性角化障碍,慢性疲劳综合征,骨髓移植(BMT)后患者出现OSCC的风险增加。OSCC在综合征患者和BMT后的总体患病率分别为0.65%(95%CI=0.13-3.11,p<0.01)和5.83%(95%CI=0.00-30.90,p<0.01),分别。证据的确定性是中等的。这项研究表明,一些系统条件易患OSCC。这些结果对系统性受损患者的OSCC筛查具有影响。
    This study aimed to map systemic alterations predisposing to oral squamous cell carcinoma (OSCC) onset. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Five databases were used to access (1) reports of OSCC co-occurring in patients with systemic conditions, (2) prevalence of OSCC among these patients, and (3) clinicopathological profiles. Data from more than 1 million patients worldwide showed that Fanconi\'s anemia, xeroderma pigmentosum, dyskeratosis congenital, chronic fatigue syndrome, and patients post bone marrow transplantation (BMT) present increased risk for OSCC development. The overall prevalence of OSCC in syndromic patients and post-BMT were 0.65% (95% CI = 0.13-3.11, p < 0.01) and 5.83% (95% CI = 0.00-30.90, p < 0.01), respectively. The certainty of the evidence was moderate. This study demonstrated that some systemic conditions predispose to OSCC. These results present an impact on the screening of OSCC in systemically compromised patients.
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  • 文章类型: Journal Article
    预测具有疾病家族史的慢性病发展的测试变得越来越可用,并且可以确定可能从预防性干预措施中受益最多的人。重要的是要了解这些预测方法的可接受性,以便为支持决策的工具的开发提供信息。虽然缺乏许多疾病的数据,数据可用于缺血性心脏病(IHD).因此,这项研究调查了那些有IHD家族史的人进行预测性测试的意愿,以及测试结果对风险相关行为的影响。
    Medline,EMBASE,PsycINFO,搜索LILACS和灰色文献。主要研究,包括有IHD家族史的成年参与者,并评估预测性检验。还包括定性和定量结果,用于衡量进行预测性测试的意愿以及测试结果对风险相关行为的影响。有关研究目的的数据,参与者,设计,预测性检验,提取干预措施和发现。使用评估来自各种领域的研究论文的标准质量评估标准和进行的叙事综合来评估研究质量。
    纳入了五项定量研究和两项定性研究。这些是在荷兰进行的(n=1),澳大利亚(n=1),美国(n=1)和英国(n=4)。方法学质量从中等到良好。三项研究发现,大多数亲戚愿意接受预测性测试,报告家族史(n=2)和全科医生(GP)推荐(n=1)作为感兴趣的决定因素。评估测试结果对行为意图的影响的研究(n=2)发现,参与体育锻炼和戒烟的意图增加,但对于那些患IHD风险增加的人来说,饮食不健康。在检查实际行为变化的研究中(n=2),大多数参与者报告说至少有一种预防行为,特别是药物依从性。
    结果表明,有IHD家族史的人可以接受预测方法,并对健康行为产生积极影响。需要进一步的研究来全面了解IHD和其他慢性疾病的预测方法。
    Tests to predict the development of chronic diseases in those with a family history of the disease are becoming increasingly available and can identify those who may benefit most from preventive interventions. It is important to understand the acceptability of these predictive approaches to inform the development of tools to support decision making. Whilst data are lacking for many diseases, data are available for ischemic heart disease (IHD). Therefore, this study investigates the willingness of those with a family history of IHD to take a predictive test, and the effect of the test results on risk-related behaviours.
    Medline, EMBASE, PsycINFO, LILACS and grey literature were searched. Primary research, including adult participants with a family history of IHD, and assessing a predictive test were included. Qualitative and quantitative outcomes measuring willingness to take a predictive test and the effect of test results on risk-related behaviours were also included. Data concerning study aims, participants, design, predictive test, intervention and findings were extracted. Study quality was assessed using the Standard Quality Assessment Criteria for Evaluating Research Papers from a Variety of Fields and a narrative synthesis undertaken.
    Five quantitative and two qualitative studies were included. These were conducted in the Netherlands (n = 1), Australia (n = 1), USA (n = 1) and the UK (n = 4). Methodological quality ranged from moderate to good. Three studies found that most relatives were willing to take a predictive test, reporting family history (n = 2) and general practitioner (GP) recommendation (n = 1) as determinants of interest. Studies assessing the effect of test results on behavioural intentions (n = 2) found increased intentions to engage in physical activity and smoking cessation, but not healthy eating in those at increased risk of developing IHD. In studies examining actual behaviour change (n = 2) most participants reported engaging in at least one preventive behaviour, particularly medication adherence.
    The results suggests that predictive approaches are acceptable to those with a family history of IHD and have a positive impact on health behaviours. Further studies are needed to provide a comprehensive understanding of predictive approaches in IHD and other chronic conditions.
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