Stange K C, Kelly R, Chao J, Zyzanski S J, Shank J C, Jaén C R, Melnikow J, Flocke S
Department of Family Medicine, Case Western Reserve University, Fairview General Hospital, Cleveland, OH 44106.
J Fam Pract. 1992 Apr;34(4):409-16.
No large-scale work has yet assessed the reactions of physicians to the report of the US Preventive Services Task Force (USPSTF), despite its potential for fostering a consensus among practitioners. This study undertook a survey of family physicians to assess their agreement with the recommendations of the Task Force.
A survey containing the verbatim summary recommendations of the USPSTF was mailed to all 1784 active members of the Ohio Academy of Family Physicians.
No evidence of selection bias was found among the 898 responding physicians. The average physician agreed with 88% of the recommendations. For a number of recommendations, however, particularly those in which the Task Force differed with the American Cancer Society, there was a high level of disagreement. Physician disagreement with the recommendations was associated with older age, not having completed a residency, male sex, less prior exposure to the USPSTF guidelines, and greater perception of the impracticality of applying them.
The high level of agreement with most USPSTF recommendations implies that they represent an emerging consensus about which preventive services should be delivered. Attempts at USPSTF guideline dissemination should focus on recommendations with high agreement. Additional research is needed to assess the reasons for disagreement.
尽管美国预防服务工作组（USPSTF）的报告有可能促进从业者之间达成共识，但尚未有大规模研究评估医生对该报告的反应。本研究对家庭医生进行了一项调查，以评估他们对工作组建议的认同程度。
一份包含USPSTF逐字总结建议的调查问卷被邮寄给俄亥俄州家庭医生学会的所有1784名在职会员。
在898名回复的医生中未发现选择偏倚的证据。医生平均认同88%的建议。然而，对于一些建议，尤其是那些工作组与美国癌症协会存在分歧的建议，存在高度的不同意见。医生对建议的不同意见与年龄较大、未完成住院医师培训、男性、较少接触过USPSTF指南以及更多地认为应用这些建议不切实际有关。
对大多数USPSTF建议的高度认同意味着它们代表了关于应提供哪些预防服务的一种新兴共识。USPSTF指南的传播应侧重于高度认同的建议。需要进行更多研究以评估不同意见的原因。
