Schulte J M, Moore M, Kistler V, Margraf P, Christman R, Valway S E, Onorato I M, Stader B
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Am J Prev Med. 1999 Apr;16(3):178-81. doi: 10.1016/s0749-3797(98)00155-x.
To assess tuberculin skin testing practices of physicians after community-wide screening of 1400 children exposed to a pediatrician with active tuberculosis (TB).
A self-administered questionnaire.
Medium-sized city in eastern Pennsylvania.
Pediatricians and family practitioners seeing pediatric patients.
Percentages of physicians who followed published recommendations for placement and reading of TB skin tests published by the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC).
Questionnaires were completed by 60/80 (75%) physicians. The 60 physicians had practiced a mean of 17 years (range 3-38 years), and only one did not do TB skin testing for pediatric patients. The 59 physicians doing TB skin testing reported routinely tuberculin testing more than 900 children per month. Only 8/59 (14%) physicians followed published guidelines for placement and reading of tuberculin tests. Those physicians screened 158 (17%) of the pediatric patients undergoing TB skin testing in a typical month.
In this community where a highly publicized TB case prompted massive pediatric screening, most physicians seeing children in private practice do not follow standard TB skin testing guidelines. Increased understanding of how private-practice physicians learn about and decide to use recommended standards are needed if tuberculin tests are to be correctly performed and TB appropriately diagnosed.
在对1400名接触患有活动性结核病儿科医生的儿童进行社区范围筛查后，评估医生的结核菌素皮肤试验操作情况。
自行填写的问卷。
宾夕法尼亚州东部的中型城市。
诊治儿科患者的儿科医生和家庭医生。
遵循美国儿科学会（AAP）和疾病控制与预防中心（CDC）发布的结核菌素皮肤试验放置和解读建议的医生百分比。
80名医生中有60名（75%）完成了问卷。这60名医生的平均执业年限为17年（范围3 - 38年），只有1名医生不为儿科患者进行结核菌素皮肤试验。进行结核菌素皮肤试验的59名医生报告称，每月常规对900多名儿童进行结核菌素检测。只有8/59（14%）的医生遵循了已发布的结核菌素试验放置和解读指南。在一个典型月份中，这些医生对接受结核菌素皮肤试验的儿科患者中的158名（17%）进行了筛查。
在这个因一起广为人知的结核病病例促使进行大规模儿科筛查的社区，大多数私人执业的儿科医生未遵循标准的结核菌素皮肤试验指南。如果要正确进行结核菌素试验并准确诊断结核病，就需要进一步了解私人执业医生如何了解并决定采用推荐标准。
