Narayanaswami Pushpa, Hahne Jill C
Dept. of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, TCC-8, Boston, MA 02215, USA.
J Neurol Sci. 2009 Jan 15;276(1-2):175-8. doi: 10.1016/j.jns.2008.09.036. Epub 2008 Nov 20.
The outcome of outpatient neurologic consultations has not been previously evaluated. There is also no data regarding patients' perceptions of outpatient neurologic consultations. In this study, we assessed the physician's evaluations of the outcome and utility of neurologic consultations by reviewing office records of 108 patients referred for consultation to a secondary level neurology clinic. Predefined criteria were used to determine diagnosis and treatment changes resulting from the consultation and the usefulness of the consultation. Outcome was defined as "resolved/improved", "unchanged", or "worse". The patients' perceptions of the usefulness of the neurologic consultations were assessed by a questionnaire survey. The questionnaire evaluated patients' perceptions of diagnosis and treatment changes, outcome and usefulness of the consultation. The physician's evaluation was compared to the patients' perceptions. Neurologic consultations resulted in diagnosis changes in 62% and treatment changes in 85%. Either diagnosis or treatment changed in 92% of consultations, which were regarded as "useful". Seventy-four percent of patients concurred with the physician's evaluation of outcome and 96% concurred that the consultation was useful. Although small, this study found that outpatient neurologic consultations result in diagnosis and treatment changes in a substantial proportion of patients.
门诊神经科会诊的结果此前尚未得到评估。关于患者对门诊神经科会诊的看法也没有相关数据。在本研究中，我们通过查阅转至二级神经科门诊进行会诊的108例患者的病历记录，评估了医生对神经科会诊结果及效用的评价。使用预定义标准来确定会诊导致的诊断和治疗变化以及会诊的有用性。结果被定义为“缓解/改善”、“未改变”或“恶化”。通过问卷调查评估患者对神经科会诊有用性的看法。该问卷评估了患者对诊断和治疗变化、会诊结果及有用性的看法。将医生的评价与患者的看法进行比较。神经科会诊导致62%的患者诊断发生变化，85%的患者治疗发生变化。92%的会诊中诊断或治疗发生了变化，这些会诊被视为“有用”。74%的患者同意医生对结果的评价，96%的患者同意会诊是有用的。尽管样本量较小，但本研究发现门诊神经科会诊在相当比例的患者中导致了诊断和治疗的变化。
