先天性甲状腺功能减退症筛查审计。
Audit of screening for congenital hypothyroidism.
作者信息
Pharoah P O, Madden M P
机构信息
Department of Public Health, University of Liverpool.
出版信息
Arch Dis Child. 1992 Sep;67(9):1073-6. doi: 10.1136/adc.67.9.1073.
The effectiveness and efficiency of the screening programme for congenital hypothyroidism in the Mersey region from 1983 to 1989 was examined by an analysis of laboratory, manual and computerised district records, case notes, and Hospital Activity Analysis data. Births from 1 January 1983 to 31 December 1989 formed the study cohort and the proportion of live births screened, age when treatment was started, validity of the screening test, and the outcome of treatment were determined. In nine out of 10 districts coverage of the neonatal population by the screening programme was incomplete and there was failure to follow up infants who had not been screened. The sensitivity of the test was 97% and the specificity was 99.9%. In 10% of the positive cases treatment was delayed beyond 21 days, the latest was 26 days. It is concluded that administrative deficiencies were predominantly responsible for the inefficiencies of the screening programme. The long term follow up of diagnosed cases should become part of the monitoring process.
通过对实验室记录、手工记录及计算机化的地区记录、病例记录和医院活动分析数据进行分析，研究了1983年至1989年默西地区先天性甲状腺功能减退症筛查项目的有效性和效率。以1983年1月1日至1989年12月31日的出生人口作为研究队列，确定了接受筛查的活产比例、开始治疗的年龄、筛查试验的有效性以及治疗结果。在10个地区中的9个，筛查项目对新生儿人群的覆盖不完整，且未对未接受筛查的婴儿进行随访。该检测的灵敏度为97%，特异度为99.9%。在10%的阳性病例中，治疗延迟超过了21天，最晚的为26天。得出的结论是，行政缺陷是筛查项目效率低下的主要原因。对确诊病例的长期随访应成为监测过程的一部分。
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