Schichtel Markus, Rose Peter W, Sellers Charlotte
Department of Primary Health Care Sciences, Oxford, UK.
Educ Prim Care. 2013 Jul;24(4):274-90. doi: 10.1080/14739879.2013.11494186.
Primary healthcare professionals seem to lack knowledge and skills in the area of diagnosing cancer which may lead to more advanced stage at diagnosis, poorer cancer survival figures and increased morbidity. The aim of this study was to examine the evidence of effectiveness of educational interventions for primary healthcare professionals to promote the early diagnosis of cancer.
We searched bibliographic databases, the grey literature and reference lists for randomised controlled trials (RCTs) of educational interventions delivered at an individual clinician and practice level.
We found sufficient evidence that interactive education, computerised reminder systems and audit and feedback delivered to clinicians may significantly increase several cancer detection measures in the short term and some evidence that they promote early diagnosis. Whilst educational outreach and local opinion leaders had some effect, formal education alone seemed ineffectual.
Certain educational interventions delivered at a clinician as well as at a practice level may promote the early diagnosis of cancer in primary care. There is currently limited evidence for their long-term sustainability and effectiveness.
基层医疗保健专业人员似乎在癌症诊断领域缺乏知识和技能，这可能导致诊断时处于更晚期阶段、癌症生存率更低以及发病率增加。本研究的目的是检验针对基层医疗保健专业人员的教育干预措施促进癌症早期诊断有效性的证据。
我们检索了书目数据库、灰色文献以及参考文献列表，以查找在个体临床医生和医疗机构层面实施的教育干预措施的随机对照试验（RCT）。
我们发现有充分证据表明，对临床医生进行的互动式教育、计算机化提醒系统以及审核与反馈可能在短期内显著提高多种癌症检测指标，并且有一些证据表明它们能促进早期诊断。虽然教育推广和当地意见领袖有一定效果，但单纯的正规教育似乎无效。
在临床医生以及医疗机构层面实施的某些教育干预措施可能促进初级保健中癌症的早期诊断。目前关于其长期可持续性和有效性的证据有限。
