Bell Douglas S, Hays Ron D, Hoffman Jerome R, Day Frank C, Higa Jerilyn K, Wilkes Michael S
Division of General Internal Medicine and Health Services Research, University of California, Davis, CA, USA.
J Gen Intern Med. 2006 Apr;21(4):310-4. doi: 10.1111/j.1525-1497.2006.00337.x. Epub 2006 Feb 22.
Although the benefits of prostate cancer screening are uncertain and guidelines recommend that physicians share the screening decision with their patients, most U.S. men over age 50 are routinely screened, often without counseling.
To develop an instrument for assessing physicians' knowledge related to the U.S. Preventive Services Task Force recommendations on prostate cancer screening.
Seventy internists, family physicians, and general practitioners in the Los Angeles area who deliver primary care to adult men.
We assessed knowledge related to prostate cancer screening (natural history, test characteristics, treatment effects, and guideline recommendations), beliefs about the net benefits of screening, and prostate cancer screening practices for men in different age groups, using an online survey. We constructed a knowledge scale having 15 multiple-choice items.
Participants' mean knowledge score was 7.4 (range 3 to 12) of 15 (Cronbach's alpha=0.71). Higher knowledge scores were associated with less belief in a mortality benefit from prostate-specific antigen (PSA) testing (r=-.49, P<.001). Participants could be categorized as low, age-selective, and high users of routine PSA screening. High users had lower knowledge scores than age-selective or low users, and they believed much more in mortality benefits from PSA screening.
Based on its internal consistency and its correlations with measures of physicians' net beliefs and self-reported practices, the knowledge scale developed in this study holds promise for measuring the effects of professional education on prostate cancer screening. The scale deserves further evaluation in broader populations.
尽管前列腺癌筛查的益处尚不明确，且指南建议医生与患者共同做出筛查决策，但大多数50岁以上的美国男性仍接受常规筛查，且往往未接受咨询。
开发一种工具，用于评估医生对美国预防服务工作组关于前列腺癌筛查建议的知识掌握情况。
洛杉矶地区70名向成年男性提供初级保健服务的内科医生、家庭医生和全科医生。
我们通过在线调查评估了与前列腺癌筛查相关的知识（自然史、检测特征、治疗效果和指南建议）、对筛查净效益的看法以及不同年龄组男性的前列腺癌筛查实践。我们构建了一个包含15个多项选择题的知识量表。
参与者在15分的量表上平均知识得分为7.4分（范围为3至12分，克朗巴哈系数=0.71）。知识得分越高，对前列腺特异性抗原（PSA）检测带来的死亡率益处的信念就越低（r = -0.49，P < 0.001）。参与者可分为常规PSA筛查的低使用者、年龄选择性使用者和高使用者。高使用者的知识得分低于年龄选择性使用者或低使用者，且他们更坚信PSA筛查能带来死亡率益处。
基于其内部一致性以及与医生净信念和自我报告实践测量指标的相关性，本研究开发的知识量表有望用于衡量专业教育对前列腺癌筛查的影响。该量表值得在更广泛的人群中进行进一步评估。
