Eaton A K, Furniss S J, Snoad R J, Newman H N
Department of Periodontology, University College, Eastman Dental Institute for Oral Healthcare Sciences, London, UK.
J Int Acad Periodontol. 2001 Jan;3(1):7-13.
There have been concerns about the quality of referral letters received by specialist periodontists. This retrospective study aimed to assess the quality of all referral letters received over a nine month period, by a specialist periodontist working in a publicly financed community clinic, and to compare the results with those obtained from a study which assessed referral letters received by the periodontal department of a London teaching hospital during the same period. After the assessors had trained for intra- and inter-examiner reproducibility, the letters were assessed using the Categorisation System for Periodontal Referral Quality (CSPRQ) (Snoad et al., 1999). The year and country of qualification (UK or non-UK), and possession or otherwise of postgraduate qualifications for each of the referring dentists was ascertained from the UK Dentists Register. The results from this study and those from the hospital study were statistically tested using the Chi-squared test. Before the studies commenced the assessors achieved 100% inter-examiner reproducibility when applying the CSPRQ. A total of 114 letters was received, six of which were excluded. Of the remaining 108, 38 were categorised as of an acceptable standard. There were differences in the performance of dentists from different age groups in that 56% of letters from those qualified from 10-20 years, 29% of those from dentists qualified < 10 years and 27% of those qualified > 20 years were of an acceptable standard. The results were broadly similar to those of the hospital study except that there was a statistically significant difference (P< 0.05) between the quality of referrals from dentists qualified between 10 and 20 years and those with non-UK primary qualifications. It was concluded that the overall quality of referral letters assessed in this study was poor and that the CSPRQ provided a highly reproducible technique for assessing the quality of periodontal referral letters.
专科牙周病医生收到的转诊信质量一直备受关注。这项回顾性研究旨在评估一家公立社区诊所的专科牙周病医生在九个月期间收到的所有转诊信的质量，并将结果与同期对伦敦一家教学医院牙周科收到的转诊信进行评估的研究结果进行比较。在评估人员接受了考官内部和考官间再现性培训后，使用牙周转诊质量分类系统（CSPRQ）（斯诺德等人，1999年）对信件进行评估。从英国牙医登记册中确定每位转诊牙医的资格年份和国家（英国或非英国）以及是否拥有研究生学历。使用卡方检验对本研究结果和医院研究结果进行统计学检验。在研究开始前，评估人员在应用CSPRQ时实现了100%的考官间再现性。共收到114封信，其中6封被排除。在其余108封信中，38封被归类为可接受标准。不同年龄组的牙医表现存在差异，10至20年资格的牙医所写信件中有56%、资格小于10年的牙医所写信件中有29%、资格大于20年的牙医所写信件中有27%达到可接受标准。结果与医院研究的结果大致相似，只是10至20年资格的牙医的转诊质量与具有非英国初始资格的牙医之间存在统计学显著差异（P<0.05）。研究得出结论，本研究中评估的转诊信总体质量较差，CSPRQ为评估牙周转诊信的质量提供了一种高度可重复的技术。
