Med J Aust. 1991 Apr 15;154(8):511-8. doi: 10.5694/j.1326-5377.1991.tb119443.x.
To examine the impact of the introduction of dry chemistry pathology in general practice.
A two-period crossover trial in two groups of general practices.
Twenty-eight general practices with an interest in participating in a trial of the new technology were selected from practices related to the coordinating hospitals.
Each practice was observed in its usual operation for one of the two study periods and observed using a dry chemistry analyser during the other.
Laboratory pathology tests and analyser tests were recorded during the study period. General practice records were searched to assess the impact of dry chemistry pathology on the detection of new disease (anaemia) and the control of existing disease (diabetes; and hyperkalaemia or hypokalaemia). Questionnaires were given to patients and general practitioners to assess their perceptions of the new technology. Imprecision of the analysers was assessed by use of their internal control material and inaccuracy was assessed by split sample analysis in comparison with standard laboratory tests.
Use of analysers was associated with a 2% non-significant reduction in the use of laboratory tests. For those tests with a direct analyser equivalent, there was a 9% and 13% reduction in biochemical and haematological tests respectively. However, there was a 46% increase in the total number of biochemical tests--by laboratory or analyser--during the period when analysers were available. No effect on the detection of new disease or the control of existing disease was observed. Patients rated analysers highly and rated laboratory tests less highly when analysers were available. General practitioners typically reported that the analysers made a minor contribution to their practice and did not fit in easily. The level of analytical reliability of the analysers was not always acceptable.
General practices varied greatly in their use of the analysers. This experience of dry chemistry pathology in general practice suggests that its application is limited.
研究在全科医疗中引入干化学病理学的影响。
在两组全科医疗机构中进行的两阶段交叉试验。
从与协作医院相关的医疗机构中选取了28家有兴趣参与新技术试验的全科医疗机构。
在两个研究阶段中的一个阶段，观察每家医疗机构的常规运作情况；在另一个阶段，使用干化学分析仪进行观察。
在研究期间记录实验室病理学检测和分析仪检测情况。检索全科医疗记录，以评估干化学病理学对新疾病（贫血）检测和现有疾病（糖尿病；高钾血症或低钾血症）控制的影响。向患者和全科医生发放问卷，以评估他们对新技术的看法。通过使用分析仪的内部对照物质评估分析仪的不精密度，并通过与标准实验室检测进行拆分样本分析评估其不准确性。
使用分析仪与实验室检测使用量减少2%（无统计学意义）相关。对于有直接等效分析仪检测的那些检测项目，生化检测和血液学检测分别减少了9%和13%。然而，在可使用分析仪的期间，通过实验室或分析仪进行的生化检测总数增加了46%。未观察到对新疾病检测或现有疾病控制有影响。当有分析仪可用时，患者对分析仪评价很高，对实验室检测评价较低。全科医生通常报告称，分析仪对他们的业务贡献不大，且不容易融入。分析仪的分析可靠性水平并非总是可接受的。
全科医疗机构在分析仪的使用方面差异很大。全科医疗中干化学病理学的这一经验表明其应用有限。
