Moreno Gilberto, Tran Hue, Chia Alvin L K, Lim Adrian, Shumack Stephen
St George Dermatology and Skin Cancer Centre, Kogarah, New South Wales, Australia.
Australas J Dermatol. 2007 May;48(2):77-82. doi: 10.1111/j.1440-0960.2007.00340.x.
A prospective study was conducted to assess general practitioners' diagnostic skills in a referral setting. The primary objective was to identify general practitioners' strengths and weaknesses in diagnosing a broad spectrum of skin conditions. The diagnoses of 315 skin conditions made by 165 general practitioners were compared with a reference standard. The reference standard was made up of 73 histopathological diagnoses, 119 dermatologists' clinical diagnoses and 123 dermatologists' diagnoses plus follow up. The diagnoses assigned by referring general practitioners were consistent with dermatologists' clinical diagnoses and histology (where available) in 57% of cases. General practitioners made the correct diagnosis in 44% of cases when compared with histopathology. General practitioners were generally good at diagnosing conditions such as acne, warts, rosacea, molluscum contagiosum, vitiligo and skin tags. The proportion of correct diagnoses for premalignant and malignant skin tumours was 47%, and that of skin rashes requiring a diagnosis was 44%. Further education of general practitioners would help to improve their diagnostic skills in certain skin conditions.
开展了一项前瞻性研究，以评估全科医生在转诊环境中的诊断技能。主要目的是确定全科医生在诊断多种皮肤疾病方面的优势和不足。将165名全科医生做出的315例皮肤疾病诊断与参考标准进行比较。参考标准由73例组织病理学诊断、119例皮肤科医生的临床诊断以及123例皮肤科医生的诊断加随访组成。转诊的全科医生给出的诊断在57%的病例中与皮肤科医生的临床诊断和组织学（如可获得）一致。与组织病理学相比，全科医生在44%的病例中做出了正确诊断。全科医生通常擅长诊断痤疮、疣、玫瑰痤疮、传染性软疣、白癜风和皮赘等疾病。癌前和恶性皮肤肿瘤的正确诊断比例为47%，需要诊断的皮疹的正确诊断比例为44%。对全科医生进行进一步教育将有助于提高他们在某些皮肤疾病方面的诊断技能。
