Screening for Chronic Obstructive Pulmonary Disease US Preventive Services Task Force Recommendation Statement
Screening for Chronic Obstructive Pulmonary Disease US Preventive Services Task Force Recommendation Statement
复制标题
DOI：
10.1001/jama.2016.2638
复制
发表时间：
2016-04-05
影响因子：
120.7
通讯作者：
Pignone, Michael P.
中科院分区：
文献类型：
--
作者：
Siu, Albert L.;Bibbins-Domingo, Kirsten;Pignone, Michael P.
重要性40岁至79岁的美国成年人中约有14%患有慢性阻塞性肺疾病(COPD)，它是美国第三大死因。目的更新2008年美国预防服务工作组(USPSTF)关于在无症状成年人中筛查COPD的建议。EVIDENCE综述USPSTF回顾了在无症状成年人(那些没有识别或报告呼吸道症状的人)中筛查COPD是否会改善健康结果的证据。USPSTF审查了筛查工具(包括筛查前问卷和肺活量测定)的诊断准确性；筛查COPD是否改善了有针对性的预防服务的提供和接受，如戒烟或相关免疫；以及筛查和治疗轻中度COPD可能造成的危害。与2008年类似，USPSTF没有发现证据表明在无症状的人中筛查COPD可以改善与健康相关的生活质量、发病率或死亡率。USPSTF确定，在出现症状之前及早发现COPD并不会改变疾病的进程或改善患者的预后。USPSTF得出的结论是，在无症状的人中筛查COPD没有净益处。结论和建议USPSTF建议不要对无症状的成年人进行COPD筛查。(D)建议)
IMPORTANCE About 14% of US adults aged 40 to 79 years have chronic obstructive pulmonary disease (COPD), and it is the third leading cause of death in the United States. Persons with severe COPD are often unable to participate in normal physical activity due to deterioration of lung function.OBJECTIVE To update the 2008 US Preventive Services Task Force (USPSTF) recommendation on screening for COPD in asymptomatic adults.EVIDENCE REVIEW The USPSTF reviewed the evidence on whether screening for COPD in asymptomatic adults (those who do not recognize or report respiratory symptoms) improves health outcomes. The USPSTF reviewed the diagnostic accuracy of screening tools (including prescreening questionnaires and spirometry); whether screening for COPD improves the delivery and uptake of targeted preventive services, such as smoking cessation or relevant immunizations; and the possible harms of screening for and treatment of mild to moderate COPD.FINDINGS Similar to 2008, the USPSTF did not find evidence that screening for COPD in asymptomatic persons improves health-related quality of life, morbidity, or mortality. The USPSTF determined that early detection of COPD, before the development of symptoms, does not alter the course of the disease or improve patient outcomes. The USPSTF concludes with moderate certainty that screening for COPD in asymptomatic persons has no net benefit.CONCLUSIONS AND RECOMMENDATION The USPSTF recommends against screening for COPD in asymptomatic adults. (D recommendation)