医学与牙科电话咨询的循证基础
The Foundation in Evidence of Medical and Dental Telephone Consultations.
作者信息
Albrecht Martina, Isenbeck Florian, Kasper Jüürgen, Mühlhauser Ingrid, Steckelberg Anke
机构信息
Faculty of Mathematics, Informatics, and Natural Sciences, Health Sciences and Education, University of Hamburg, Faculty of Health Sciences, Department of Health and Care Sciences, University of Tromsø, Norway.
出版信息
Dtsch Arztebl Int. 2016 Jun 6;113(22-23):389-95. doi: 10.3238/arztebl.2016.0389.
BACKGROUND
Patients can only make well-informed decisions if the information they are given by health professionals is based on scientific evidence. In this study, we assessed the foundation in evidence of free, publicly available telephone consultations in Germany.
METHODS
From March 2013 to January 2014, four hidden clients seeking information asked standardized questions about three medical topics (screening for colorectal cancer, for glaucoma, and for trisomy 21) and three dental ones (the sealing of dental fissures, professional dental cleaning, and mercury detoxification). Depending on the topic, the questions addressed such issues as the risk of disease and the purpose, content, validity, benefits, and risks of potential diagnostic and therapeutic measures. All identifiable telephone consultation services that provided counselling on the above topics were included in the study (23 government-sponsored institutions, 31 institutions independently run by physicians, 521 institutions under religious auspices, 25 dental counselling services).
RESULTS
Of the 599 telephone consultation services that were identified, 567 were contacted; 404 did not offer any relevant counselling. A total of 293 conversations were held with the remaining 163 consultation services. Six of these conversations fully met predefined criteria for evidence-based counselling. The percentage of appropriate answers to the key questions on each topic was 5% for colorectal cancer screening (7/140), 23.8% for glaucoma screening (25/105), 33.9% for trisomy 21 screening (121/357), 27.5% for the sealing of dental fissures (28/102), 16.2% for professional dental cleaning (19/117), and 12.9% for mercury detoxification (12/93). The percentage of appropriate answers also varied depending on the type of institution: 26.8% for government-sponsored institutions (67/250), 4.5% for institutions independently run by physicians (4/88), and 31.1% for institutions under religious auspices (82/264).
CONCLUSION
The medical and dental counselling now offered over the telephone by the types of institutions included in this study does not satisfy the criteria for evidence-based health information.
背景
只有当医疗专业人员提供给患者的信息基于科学证据时，患者才能做出明智的决定。在本研究中，我们评估了德国免费公开电话咨询的证据基础。
方法
2013年3月至2014年1月，四名寻求信息的隐蔽客户针对三个医学主题（结直肠癌筛查、青光眼筛查和21三体综合征筛查）以及三个牙科主题（牙面窝沟封闭、专业牙齿清洁和汞解毒）询问了标准化问题。根据主题不同，问题涉及疾病风险以及潜在诊断和治疗措施的目的、内容、有效性、益处和风险等方面。所有就上述主题提供咨询的可识别电话咨询服务均纳入研究（23个政府资助机构、31个医生独立运营机构、521个宗教机构下属机构、25个牙科咨询服务机构）。
结果
在识别出的599个电话咨询服务中，联系了567个；404个未提供任何相关咨询。与其余163个咨询服务机构共进行了293次通话。其中6次通话完全符合循证咨询的预定义标准。每个主题关键问题的恰当回答百分比分别为：结直肠癌筛查5%（7/140）、青光眼筛查23.8%（25/105）、21三体综合征筛查33.9%（121/357）、牙面窝沟封闭27.5%（28/102）、专业牙齿清洁16.2%（19/117）、汞解毒12.9%（12/93）。恰当回答的百分比也因机构类型而异：政府资助机构为26.8%（67/250）、医生独立运营机构为4.5%（4/88）、宗教机构下属机构为31.1%（82/264）。
结论
本研究中所涵盖的各类机构目前通过电话提供的医疗和牙科咨询不符合循证健康信息的标准。
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