Necropsy evidence of detection bias in the diagnosis of lung cancer.
Necropsy evidence of detection bias in the diagnosis of lung cancer.
复制标题
肺癌诊断中检测偏差的尸检证据。
DOI：
10.1001/archinte.1986.00360210059009
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发表时间：
1986
影响因子：
--
通讯作者：
C. Wells
中科院分区：
文献类型：
--
作者：
M. Mcfarlane;A. Feinstein;C. Wells
在1971-1982年间尸检发现的153例肺癌患者中，有26%的患者生前诊断不正确。正确的生前诊断的可能性与患者的吸烟史和吸烟量、症状表现和癌症的解剖广泛性有关。然而，吸烟仍然对症状相似、解剖扩散程度相似的患者起到诊断作用。此外，如果存在病变，胸片更有可能被放射学解释为吸烟者的癌症。结果表明，吸烟者在诊断肺癌方面受到优先考虑。这种检测偏差可能会产生不利的科学后果，包括剥夺不吸烟者获得适当治疗的机会，导致对吸烟/肺癌关联的真实规模的错误高估，以及分散病因学对其他可能导致肺癌的因素的注意力。
The correct diagnosis had not been made during life in 26% of 153 patients with lung cancer found in necropsies performed between 1971 and 1982. The likelihood of a correct antemortem diagnosis showed distinctive gradients in relation to the patients' history and amount of cigarette smoking, symptomatic manifestations, and anatomic extensiveness of the cancers. However, cigarette smoking still exerted a diagnostic effect in patients with similar symptoms and similar degrees of anatomic spread. Furthermore, if a lesion was present, chest films were more likely to be radiologically interpreted as a cancer in smokers. The results suggest that smokers receive preferential consideration regarding the diagnosis of lung cancer. This detection bias can have adverse scientific consequences in depriving nonsmokers of suitable therapy, in leading to falsely high estimates of the true magnitude of the smoking/lung cancer association, and in distracting etiologic attention from other agents that may cause lung cancer.