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本文引用的文献

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Increasing the number of trainees in general surgery residencies: is there capacity?增加普通外科住院医师培训人数:是否有能力?
Acad Med. 2011 May;86(5):599-604. doi: 10.1097/ACM.0b013e318212eb17.
3
Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support.研究电子数据采集(REDCap)——一种用于提供转化研究信息学支持的元数据驱动方法和工作流程。
J Biomed Inform. 2009 Apr;42(2):377-81. doi: 10.1016/j.jbi.2008.08.010. Epub 2008 Sep 30.
4
The health workforce: a position statement.卫生人力:一份立场声明。
Ann Surg. 2007 Oct;246(4):525-6. doi: 10.1097/SLA.0b013e3181571b49.
5
Prognosis and treatment of primary deep soft tissue sarcomas.
Anticancer Res. 2007 Jul-Aug;27(4C):2759-64.
6
Prognostic effect of re-excision in adult soft tissue sarcoma of the extremity.肢体成人软组织肉瘤再次切除的预后影响
Ann Surg Oncol. 2006 Jan;13(1):110-7. doi: 10.1245/ASO.2006.03.030. Epub 2006 Jan 1.
7
Soft-tissue sarcoma.软组织肉瘤
N Engl J Med. 2005 Nov 24;353(21):2303-4; author reply 2303-4. doi: 10.1056/NEJM200511243532121.
8
Soft tissue sarcomas of the extremities.四肢软组织肉瘤
Proc (Bayl Univ Med Cent). 2003 Jul;16(3):285-90. doi: 10.1080/08998280.2003.11927915.
9
Dermatofibrosarcoma protuberans: A clinicopathologic analysis of patients treated and followed at a single institution.隆突性皮肤纤维肉瘤:对在单一机构接受治疗及随访的患者的临床病理分析
Cancer. 2000 Jun 15;88(12):2711-20.
10
Predictors of functional outcomes following limb salvage surgery for lower-extremity soft tissue sarcoma.下肢软组织肉瘤保肢手术后功能结局的预测因素。
J Surg Oncol. 2000 Apr;73(4):206-11. doi: 10.1002/(sici)1096-9098(200004)73:4<206::aid-jso4>3.0.co;2-5.

住院医师培训对正确诊断肢体软组织肉瘤的影响。

Influence of resident education in correctly diagnosing extremity soft tissue sarcoma.

作者信息

Alamanda Vignesh K, Crosby Samuel N, Mathis Shannon L, Archer Kristin R, Terhune Kyla P, Holt Ginger E

机构信息

Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Suite 4200, Nashville, TN 37232-8774, USA.

出版信息

Sarcoma. 2013;2013:679323. doi: 10.1155/2013/679323. Epub 2013 Apr 18.

DOI:10.1155/2013/679323
PMID:23710127
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3654354/
Abstract

Background. One-third of all extremity soft tissue sarcomas are misdiagnosed and inappropriately excised without proper preoperative diagnosis and planning. This study aimed at examining the clinical judgment of residents in both general and orthopaedic surgery and at determining whether resident education plays a role in appropriately managing unknown soft tissue masses. Methods. A case-based survey was used to assess clinical decisions, practice patterns, and demographics. Aggregate response for all of the clinical cases by each respondent was correlated with the selections made for practice patterns and demographic data. Results. A total of 381 responses were returned. A higher percentage of respondents from the orthopaedic group (84.2%) noted having a dedicated STS rotation as compared to the general surgery group (35.8%) P < 0.001. Depth, size, and location of the mass, rate of growth, and imaging characteristics were considered to be important factors. Each additional year of training resulted in 10% increased odds of selecting the correct clinical decision for both groups. Conclusion. Our study showed that current residents in both orthopaedic surgery and general surgery are able to appropriately identify patients with suspicious masses. Continuing education in sarcoma care should be implemented beyond the years of residency training.

摘要

背景。所有肢体软组织肉瘤中有三分之一在未进行适当的术前诊断和规划的情况下被误诊并被不恰当地切除。本研究旨在检验普通外科和骨科住院医师的临床判断能力,并确定住院医师培训在妥善处理不明软组织肿块方面是否发挥作用。方法。采用基于病例的调查来评估临床决策、实践模式和人口统计学特征。每位受访者对所有临床病例的总体回答与针对实践模式和人口统计学数据所做的选择相关联。结果。共收到381份回复。与普通外科组(35.8%)相比,骨科组中更高比例的受访者(84.2%)指出有专门的软组织肉瘤轮转经历(P < 0.001)。肿块的深度、大小和位置、生长速度以及影像学特征被认为是重要因素。两组中,每增加一年培训,做出正确临床决策的几率就增加10%。结论。我们的研究表明,目前普通外科和骨科的住院医师能够恰当地识别患有可疑肿块的患者。肉瘤护理方面的继续教育应在住院医师培训年限之后继续开展。