美国预防临床服务指南工作组《慢性阻塞性肺疾病筛查推荐意见》更新与解读

Interpretation of the Recommendation Statement by the USPSTF on the Screening for Chronic Obstructive Pulmonary Disease

慢性阻塞性肺疾病(COPD)是严重危害人类健康的常见病,亦是导致死亡的重要病因,且极大部分诊断不足。COPD筛查是否可以实现疾病早期诊断并改善患者预后?2022年美国预防临床服务指南工作组(U.S.Preventive Services Task Force,USPSTF)针对无症状成年人,通过评估最新研究证据并分析COPD筛查的获益和危害,更新发布了《慢性阻塞性肺疾病筛查推荐意见》(以下简称推荐)。基于有限的证据,USPSTF提出了D级推荐(中度确定筛查没有净获益),不推荐对无症状成年人进行COPD筛查,该推荐与2016版一致。本文将总结分析该推荐的核心要点及其对我国全科医生的指导意义。

Chronic obstructive pulmonary disease(COPD)is a common disease that seriously harms human health,and it is also a leading cause of death,with a large number of cases being underdiagnosed.Can COPD screening enable early diagnosis of the disease and improve patient outcomes?In 2022,the U.S.Preventive Services Task Force(USPSTF)updated its"Chronic Obstructive Pulmonary Disease Screening Recommendation Statement"(hereinafter referred to as the"Recommendation")for asymptomatic adults by evaluating the latest research evidence regarding the benefits and harms of COPD screening.Based on limited evidence,the USPSTF issused a'D'statement(there is moderate certainty that the screening has no net benefit)and recommends against COPD screening for asymptomatic adults,which is consistent with the 2016 version.The current article interprets the principles of this Recommendation in the context of Chinese general practice.