Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire ST5 5BG, UK.
J Clin Epidemiol. 2011 May;64(5):547-55. doi: 10.1016/j.jclinepi.2010.06.002. Epub 2010 Oct 13.
Family practitioner diagnostic labels applied in consultation provide a signpost for treatment and management. Yet, it is unknown whether each label reflects the health of the respective patient group.
Consultation records of 7,799 patients aged 50 years and older from six family practices were linked to a cross-sectional baseline health survey. Associations between six mutually exclusive cardiovascular disease and nine mutually exclusive musculoskeletal disorder categories, and physical health severity as measured by the Short Form-12 questionnaire were examined.
There were 2,447 (31.4%) cardiovascular disease and 3,321 (42.6%) musculoskeletal disorder consulters. The mean physical health scores ranged from 38.38 (95% confidence interval [CI]: 37.8-39.0) for hypertension to the poorest score of health 28.98 (95% CI: 27.5-30.5) for consulters with heart failure, whereas in the musculoskeletal disorder group, scores ranged from 44.85 (95% CI: 42.2-47.5) for soft tissue disorder to 28.79 (95% CI: 26.8-30.8) for consulters with inflammatory polyarthropathy (trend P<0.001). This trend in the association between diagnostic categories and physical health severity within both spectrums remained after adjustment for confounders.
Specific diagnostic labels for selected chronic illness indicate the severity of physical health for the corresponding consulting population.
家庭医生在就诊时给出的诊断标签为治疗和管理提供了方向。然而，目前尚不清楚每个标签是否反映了相应患者群体的健康状况。
将来自六个家庭诊所的 7799 名 50 岁及以上患者的就诊记录与横断面基线健康调查相联系。检查了六个相互排斥的心血管疾病类别和九个相互排斥的肌肉骨骼疾病类别与身体健康严重程度（通过简短形式-12 问卷测量）之间的关联。
有 2447 名（31.4%）心血管疾病患者和 3321 名（42.6%）肌肉骨骼疾病患者。身体健康评分的平均值范围从高血压的 38.38（95%置信区间[CI]：37.8-39.0）到心力衰竭患者的最差健康评分 28.98（95% CI：27.5-30.5），而在肌肉骨骼疾病组中，评分范围从软组织疾病的 44.85（95% CI：42.2-47.5）到炎症性多关节炎患者的 28.79（95% CI：26.8-30.8）（趋势 P<0.001）。在调整了混杂因素后，这种在两个范围内诊断类别与身体健康严重程度之间的关联趋势仍然存在。
特定的慢性疾病诊断标签表明了相应就诊人群的身体健康严重程度。
