Rosenberg M, Commerford K, Driever M
Internal Medicine Residency Program, Providence Medical Center, Portland, OR 97213.
J Gen Intern Med. 1991 Nov-Dec;6(6):529-34. doi: 10.1007/BF02598222.
To compare the diagnostic accuracies of internal medicine and family medicine residents in identifying psychosocial distress in ambulatory patients.
410 consecutive patients in two hospital-based residency clinics were enrolled. Psychosocial distress was assessed using the General Health Questionnaire (GHQ). Residents, blinded to the goals of the study and the results of the GHQ, documented clinically identified psychosocial distress.
Overall concordance between the residents and the GHQ in identifying the presence or absence of psychosocial distress was 60%. There was no difference in the diagnostic performances of the two resident groups. Sensitivity for the identification of psychosocial distress when the resident groups were combined was 32.3%.
The concordance between a commonly used, well-validated screening test for psychosocial distress and resident diagnosis was 60%. This may reflect the need for more effective training of residents in this area of diagnosis or the need for better screening methods.
比较内科住院医师和家庭医学住院医师识别门诊患者心理社会困扰的诊断准确性。
招募了两家医院住院医师诊所的410例连续患者。使用一般健康问卷（GHQ）评估心理社会困扰。住院医师在对研究目的和GHQ结果不知情的情况下，记录临床识别出的心理社会困扰。
住院医师与GHQ在识别心理社会困扰是否存在方面的总体一致性为60%。两组住院医师的诊断表现无差异。将住院医师组合后识别心理社会困扰的敏感性为32.3%。
一种常用的、经过充分验证的心理社会困扰筛查测试与住院医师诊断之间的一致性为60%。这可能反映出在该诊断领域需要对住院医师进行更有效的培训，或者需要更好的筛查方法。
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