Thorax:患者性别对特发性肺纤维化诊断的影响

2020-02-18 xing.T MedSci原创

由此可见,患者的性别会影响IPF的诊断:女性IPF可能诊断不足,而男性则诊断过度。

患者性别对特发性肺纤维化(IPF)患者具有临床和预后价值。在明确IPF诊断时,是否存在性别相关差异尚不清楚。近日,胸部疾病领域权威杂志Thorax上发表了一篇研究文章,研究人员旨在明确患者性别如何影响IPF的诊断和医师的诊断信心。

该研究是收集了单中心来源的临床病例,然后由呼吸内科医师评分以进行研究。使用临床信息,研究人员要求医师提供最多五项诊断以及他们的诊断信心。Logistic回归用于评估根据患者性别确诊IPF的几率。IPF和非IPF之间的预后判别用于评估Cox比例风险建模的诊断准确性。

404名医师对60例患者进行了评分。与女性相比,男性被诊断为IPF的频率更高(分别为37.8% vs. 10.6%;p<0.0001),并且平均诊断置信度更高(p<0.001)。校正混杂因素后,男性患者诊断IPF的机率大于女性患者(OR=3.05,95%CI为2.81至3.31)。诊断为IPF的女性患者死亡率(HR=2.21,95%CI为2.02至2.41)高于男性患者(HR=1.26,95%CI为1.20至1.33),这表明男性更容易被误诊为IPF。

由此可见,患者的性别会影响IPF的诊断:女性IPF可能诊断不足,而男性则诊断过度。

原始出处:

Deborah Assayag,et al.Patient gender bias on the diagnosis of idiopathic pulmonary fibrosis.Thorax. 2020.http://dx.doi.org/10.1136/thoraxjnl-2019-213968

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