诊断中的启示

Theoretical medicine and bioethics Pub Date : 2024-04-01 Epub Date: 2024-02-07 DOI:10.1007/s11017-023-09657-9
Bjørn Hofmann, Urban Wiesing
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引用次数: 0

摘要

几千年来,"开端 "一直是医学中的一个重要概念,通常被理解为与治疗相关的 "恰当时机"。在本研究中,我们将从诊断学的角度仔细研究 "开端"。随着技术的发展,诊断越来越早地在疾病发展过程中进行,这已成为一个非常热门的话题。检测疾病的危险因素、前兆和预测因素(生物标志物、疾病前和疾病前)导致过早诊断,即过度诊断。然而,尽管科学技术取得了巨大进步,但诊断也会出现过晚的情况。因此,正确把握诊断时机至关重要。在本文中,我们首先简要概述了 "开端"(kairos)和 "诊断"(diagnosis)这两个概念的词源和一般用法。然后,我们通过分析诊断的 "过早 "和 "过迟",以及仔细研究诊断的各个阶段,来界定诊断中的 "开端"。由此,我们将诊断中的 "开端 "定义为有可能获得足够信息以做出对患者最有帮助的诊断的时间。这让我们得出结论,开端在诊断和治疗中同样重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Kairos in diagnostics.

Kairos has been a key concept in medicine for millennia and is frequently understood as "the right time" in relation to treatment. In this study we scrutinize kairos in the context of diagnostics. This has become highly topical as technological developments have caused diagnostics to be performed ever earlier in the disease development. Detecting risk factors, precursors, and predictors of disease (in biomarkers, pre-disease, and pre-pre-disease) has resulted in too early diagnoses, i.e., overdiagnoses. Nonetheless, despite vast advances in science and technology, diagnoses also come too late. Accordingly, timing diagnostics right is crucial. In this article we start with giving a brief overview of the etymology and general use of the concepts of kairos and diagnosis. Then we delimit kairos in diagnostics by analysing "too early" and "too late" diagnosis and by scrutinizing various phases of diagnostics. This leads us to define kairos of diagnostics as the time when there is potential for sufficient information for making a diagnosis that is most helpful for the person. It allows us to conclude that kairos is as important in diagnostics as in therapeutics.

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