临床医生往往高估哮喘控制的改善情况：一项意外发现。
Clinicians tend to overestimate improvements in asthma control: an unexpected observation.
作者信息
Juniper Elizabeth F, Chauhan Anoop, Neville Edmund, Chatterjee Anwesh, Svensson Klas, Mörk Ann-Christin, Ståhl Elisabeth
机构信息
McMaster University, Hamilton, Canada.
出版信息
Prim Care Respir J. 2004 Dec;13(4):181-4. doi: 10.1016/j.pcrj.2004.04.003.
AIM
The original purpose of this study was to determine the Minimal Important Difference for the Asthma Control Questionnaire (ACQ) but an unexpected tendency of clinicians to overestimate improvements in asthma control thwarted the endeavour. We describe the observed clinician bias and discuss its implications for clinical practice and research.
METHODS
Ninety-four adults with inadequately controlled asthma received a full clinical consultation with one of nine asthma specialists. Medications were adjusted according to clinical needs. Four weeks later the same clinician estimated change in asthma control on a 15-point scale (-7 = a very great deal worse, 0 = no change, +7 a very great deal better). All patients completed the ACQ before each consultation but responses were not shown to the clinician.
RESULTS
Clinicians consistently recorded that patients improved more than their change in ACQ scores suggested (p = 0.018).
CONCLUSION
Clinicians should be aware of potential biases that may occur when estimating change in asthma control compared with measuring absolute status at each visit.
目的
本研究的最初目的是确定哮喘控制问卷（ACQ）的最小重要差异，但临床医生高估哮喘控制改善情况的意外倾向阻碍了这一努力。我们描述了观察到的临床医生偏差，并讨论了其对临床实践和研究的影响。
方法
94名哮喘控制不佳的成年人接受了9名哮喘专家之一的全面临床会诊。根据临床需要调整药物。四周后，同一名临床医生用15分制评估哮喘控制的变化（-7 = 非常差，0 = 无变化，+7 = 非常好）。所有患者在每次会诊前都完成了ACQ，但结果未向临床医生展示。
结果
临床医生始终记录患者的改善情况超过其ACQ评分变化所显示的情况（p = 0.018）。
结论
与每次就诊时测量绝对状态相比，临床医生在评估哮喘控制变化时应意识到可能出现的潜在偏差。
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