Capítulo 4. Un sistema de salud integrado y centrado en los usuarios
El entusiasmo por las pruebas diagnósticas: efectos en la salud y formas de control. Informe SESPAS 2008
Enthusiasm for diagnostic tests: health effects and their surveillance
Blanca Lumbreras
, Ildefonso Hernández Aguado
Autor para correspondencia
blumbreras@umh.es
Correspondencia: Blanca Lumbreras. Universidad Miguel Hernández. CIBER en Epidemiología y Salud Pública (CIBERESP).
Correspondencia: Blanca Lumbreras. Universidad Miguel Hernández. CIBER en Epidemiología y Salud Pública (CIBERESP).
Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. CIBER en Epidemiología y Salud Pública (CIBERESP)
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Un sistema de salud integrado y centrado en los usuarios</span>" "titulo" => "El entusiasmo por las pruebas diagnósticas: efectos en la salud y formas de control. Informe SESPAS 2008" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "216" "paginaFinal" => "222" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Blanca Lumbreras, Ildefonso Hernández Aguado" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Blanca" "apellidos" => "Lumbreras" "email" => array:1 [ 0 => "blumbreras@umh.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "Ildefonso" "apellidos" => "Hernández Aguado" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández. CIBER en Epidemiología y Salud Pública (CIBERESP)" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Blanca Lumbreras. Universidad Miguel Hernández. CIBER en Epidemiología y Salud Pública (CIBERESP)." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Enthusiasm for diagnostic tests: health effects and their surveillance" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec13677" "palabras" => array:3 [ 0 => "Prueba diagnóstica" 1 => "Efectos adversos" 2 => "Diagnóstico basado en la evidencia" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec13678" "palabras" => array:3 [ 0 => "Diagnostic test" 1 => "Adverse effects" 2 => "Evidencebased diagnosis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">A la progresiva medicalización de la vida se está añadiendo en los últimos años un desmedido interés por la salud que se convierte en una finalidad de la existencia y no en un medio. Esta nueva concepción de la salud como fin, ha motivado el crecimiento del llamado mercado secundario de la salud y de que se hable de la «sociedad de la salud» al igual que se habla de la sociedad del conocimiento. Entre los «productos» sanitarios más populares se encuentran las pruebas diagnósticas; de ahí el entusiasmo surgido por los programas de cribado o por las nuevas tecnologías genéticas, sobre todo en detección y pronóstico de cáncer. El fenómeno afecta a la salud pública por la capacidad iatrogénica de las pruebas diagnósticas y por la carga asistencial prescindible que su uso exagerado provoca. La Administración sanitaria debe encarar este reto con un diverso abanico de intervenciones, que van desde el ámbito de la gestión clínica y sanitaria a la formulación de políticas sanitarias, sin descuidar la mejora de una investigación cuya aportación al conocimiento para un diagnóstico clínico fundado es, hasta la fecha, escasa dada su irregular calidad.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">The medicalization of life has been encouraged by an excessive interest in health as an end in itself rather than as a means for a better life. This new concept of health has stimulated the growth of the secondary market of health and, in analogy with the knowledge society, the emergence of what is known as the “health society”. Among the most popular health “products” are diagnostic tests, explaining the enthusiasm for screening programs and the new genetic technologies, especially in the detection and prognosis of cancer. Because of the iatrogenic potential of diagnostic tests and the unnecessary demand caused by their excessive use, this phenomenon is a matter of public health concern. Health administrations must face this challenge with a diverse range of interventions that range from clinical management to policy formulation including the improvement of diagnostic research. The contribution of diagnostic research has so far been limited by its irregular quality.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:60 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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