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[实验室投入。全科医生对反思性测试持积极态度]

[Laboratory input. General practitioners positive about reflective testing].

作者信息

Oosterhuis Wytze P, Keuren Jeffrey F W, Verboeket-van de Venne Wilhelmine P H G, Soomers Frank L M, Stoffers H E J H Jelle, Kleinveld Henne A

机构信息

Atrium Medisch Centrum Parkstad, afd. Klinische Chemie, Heerlen, The Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2009;153:A486.

Abstract

OBJECTIVE

To investigate the opinion of general practitioners on reflective testing, i.e. the practice of additional tests being performed and comments added to the results by laboratory staff when appropriate.

DESIGN

Descriptive.

METHOD

In the eastern South Limburg region 155 general practitioners received a list of 10 fictitious patient cases, each involving the possible addition of a specific test. The general practitioners could choose what they preferred the laboratory to do: add tests, phone the general practitioner, add a written comment or do nothing. In addition the general practitioners were asked to judge the effect of additional tests and comments on patient management with respect to diagnosis, treatment and referral, using 200 laboratory reports from their own patients.

RESULTS

The response to the fictitious cases was 45%. Most general practitioners favoured the laboratory taking the initiative by adding on tests and commenting on the results in the given clinical scenarios. 78% of the questionnaires accompanying the lab reports were returned by 87% of the general practitioners. In nearly all cases (99%) the service was marked as useful. In more than half of the cases (53%) reflective testing affected the measures taken by the general practitioners.

CONCLUSION

Reflective testing was in general welcomed by the general practitioners. In the majority of cases this led to an improvement in the diagnosis or adjustment of treatment.

摘要

目的

调查全科医生对反思性检验的看法,即实验室工作人员在适当情况下进行额外检验并在结果上添加注释的做法。

设计

描述性研究。

方法

在南林堡东部地区,155名全科医生收到了一份包含10个虚拟患者病例的清单,每个病例都可能需要添加特定检验。全科医生可以选择他们希望实验室采取的做法:添加检验、致电全科医生、添加书面注释或不采取任何行动。此外,还要求全科医生利用他们自己患者的200份实验室报告,就额外检验和注释对患者管理在诊断、治疗和转诊方面的影响进行评判。

结果

对虚拟病例的回复率为45%。大多数全科医生赞成实验室在给定临床场景中主动添加检验并对结果进行注释。87%的全科医生返还了随实验室报告附带的问卷,返还率为78%。几乎在所有病例(99%)中,该服务被评为有用。在超过一半的病例(53%)中,反思性检验影响了全科医生采取的措施。

结论

反思性检验总体上受到全科医生的欢迎。在大多数情况下,这导致了诊断的改善或治疗的调整。

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