van den Brandhof Winette E, Bartelds Aad I M, Koopmans Marion P G, van Duynhoven Yvonne T H P
Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
BMC Fam Pract. 2006 Oct 2;7:56. doi: 10.1186/1471-2296-7-56.
The objective of this study was to estimate the (selective) proportion of patients consulting their GP for an episode of gastroenteritis for whom laboratory tests were requested. In addition adherence of GPs to the guidelines for diagnostic test regime was ascertained.
Data were collected from a GP network in the Netherlands. Information was also collected on the reason for requesting the test, test specifications, and test results.
For 12% of the GP patients with gastroenteritis, a stool sample was requested and tested for enteric pathogens. In most patients, the duration, followed by severity of complaints or a visit to a specific, high-risk country were reported as reasons to request laboratory diagnostics. Tests were requested most often in summer months and in February. Campylobacter (requested for 87% of the tests), Salmonella (84%), Shigella (78%) and Yersinia (56%) were most frequently included in the stool tests. Campylobacter was detected most often in patients.
Test requests did not always comply with existing knowledge of the etiology of gastroenteritis in GP patients and were not always consistent with the Dutch GP guidelines. Therefore, the data of this study can be used to develop educational approaches for GP's as well as for revision of the guidelines.
本研究的目的是估计因肠胃炎发作而咨询全科医生(GP)的患者中被要求进行实验室检查的(选择性)比例。此外,还确定了全科医生对诊断测试方案指南的遵循情况。
从荷兰的一个全科医生网络收集数据。还收集了关于要求进行检查的原因、检查规格和检查结果的信息。
在12%的患有肠胃炎的全科医生患者中,要求采集粪便样本并检测肠道病原体。在大多数患者中,报告称症状持续时间、其次是症状严重程度或前往特定高风险国家旅行是要求进行实验室诊断的原因。在夏季月份和2月,要求进行检查的情况最为常见。弯曲杆菌(在87%的检查中被要求检测)、沙门氏菌(84%)、志贺氏菌(78%)和耶尔森氏菌(56%)是粪便检查中最常检测的项目。弯曲杆菌在患者中检测到的频率最高。
检查要求并不总是符合全科医生患者肠胃炎病因的现有知识,也并不总是与荷兰全科医生指南一致。因此,本研究的数据可用于为全科医生制定教育方法以及修订指南。