Vigod Simone N, Stewart Donna E
Professor and Chair of Women's Health, University Health Network, 657 University Ave, ML 2-004, Toronto, Ontario, M5G 2N2, Canada.
BMC Womens Health. 2002 Nov 20;2(1):11. doi: 10.1186/1472-6874-2-11.
Abnormal uterine bleeding (AUB) is a common problem that affects one in five women during the pre-menopausal years. It is frequently managed by family physicians, especially in northern, rural and isolated areas where severe shortages of gynecologists exist. METHODS: We surveyed 194 family physicians in northern, rural and isolated areas of Ontario, Canada to determine their educational and resource needs for the management of AUB, with a specific focus on the relevance and feasibility of using clinical practice guidelines (CPGs). RESULTS: Most physicians surveyed did not use CPGs for the management of AUB because they did not know that such guidelines existed. The majority were interested in further education on the management of AUB through mailed CPGs and locally held training courses. A major theme among respondents was the need for more timely and effective gynecological referrals. CONCLUSION: A one-page diagnostic and treatment algorithm for AUB would be easy to use and would place minimal restrictions on physician autonomy. As the majority of physicians had Internet access, we recommend emailing and web posting in addition to mailing this algorithm. Local, hands-on courses including options for endometrial biopsy training would also be helpful for northern, rural and isolated physicians, many of whom cannot readily take time away from their practices.
异常子宫出血（AUB）是一个常见问题，在绝经前的女性中，每五人就有一人受其影响。家庭医生经常处理这一问题，尤其是在妇科医生严重短缺的加拿大安大略省北部、农村和偏远地区。方法：我们对加拿大安大略省北部、农村和偏远地区的194名家庭医生进行了调查，以确定他们在AUB管理方面的教育和资源需求，特别关注使用临床实践指南（CPG）的相关性和可行性。结果：大多数接受调查的医生没有使用CPG来管理AUB，因为他们不知道有这样的指南存在。大多数医生对通过邮寄CPG和当地举办的培训课程接受AUB管理方面的进一步教育感兴趣。受访者中的一个主要主题是需要更及时、有效的妇科转诊。结论：一份单页的AUB诊断和治疗算法易于使用，对医生的自主权限制最小。由于大多数医生可以上网，我们建议除了邮寄该算法外，还通过电子邮件和网站发布。包括子宫内膜活检培训选项在内的当地实践课程对北部、农村和偏远地区的医生也会有帮助，他们中的许多人无法轻易从工作中抽出时间。
