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概要冠心病的诊断已变得日益复杂,许多根本不完善的试验结果,应与病人的发病概率和有关的诊断结论相结合。为切实可行地研究这些问题,我们综合有关文献并讨论试验前疾病的概率<按年龄、性别、症状>,以及四种试验诊断的敏感性和特异性:即心电图负荷试验、心搏动图、铊扫描、心脏萤光检查。具有这些知识和试验结果就能应用BAYES′条件概率原理加以分析。此研究有好几个好处:它能集中许多内科医师的诊断经验,还能把各种试验前基本临床依据与各种试验后结果相结合。然后有针对地、富有成效地来总结血管造影后冠心病的概率,这不仅能帮助临床诊断,而且还能帮助对试验费用的经济问题作出选择,但是,却不能代替医师的判断力。
Summary The diagnosis of coronary heart disease has become increasingly complex, and many of the fundamentally imperfect results of the trial should be combined with the patient’s probability of morbidity and related diagnostic findings. To study these issues practically, we synthesize the literature and discuss the probabilities of pre-trial disease by sensitivity, specificity by age, sex, symptom, and diagnosis of four tests: ECG load test, cardiogram, thallium Scanning, cardiorespiratory examination. With this knowledge and test results can be applied BAYES ’conditional probability theory to be analyzed. There are several benefits to this study: It focuses on the diagnostic experience of many physicians and combines the basic clinical basis with the various post-test results. Then there is a targeted and productive summary of the probability of coronary angiography after angiography, which not only helps clinical diagnosis, but also helps to make economic choices about the cost of the trial, but does not replace the physician’s judgment.