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运动医学中运动训练师与医生诊断的准确性。

Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine.

作者信息

Lombardi Nicholas J, Tucker Bradford, Freedman Kevin B, Austin Luke S, Eck Brandon, Pepe Matthew, Tjoumakaris Fotios P

出版信息

Orthopedics. 2016 Sep 1;39(5):e944-9. doi: 10.3928/01477447-20160623-10. Epub 2016 Jul 12.

DOI:10.3928/01477447-20160623-10
PMID:27398784
Abstract

It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.].

摘要

在高中体育项目中,由认证的运动训练师对受伤的学生运动员进行评估和治疗是标准做法。在某些情况下,训练师会将运动员转介给医生进行最终的医疗处理。本研究旨在确定运动训练师和医生在评估学生运动员损伤方面的一致率。2010年至2012年期间,5所地区高中所有受伤的高中运动员都被纳入一个研究数据库。所有被转介给医生进行评估和治疗的患者都被识别并纳入本分析。共有286起事件符合纳入标准。运动训练师的评估与医生的诊断共有263例(92%)一致。在23例不一致的情况中,骨折和扭伤是最常见的损伤。卡方分析显示,在分类为脱位和脑震荡的损伤中,评估者间的一致性最高;在半月板/唇状撕裂伤和骨折中,评估者间的一致性最低。在没有确诊的情况下,医疗服务提供者之间的一致性可用于推断准确性。根据这一原则,随着运动训练师和医生之间一致性的提高,得出正确评估和治疗方案的可能性就越大。运动训练师是技术高超的专业人员,在运动损伤评估方面接受过良好的培训。当前研究表明,对运动训练师进行识别骨折方面的额外培训可能对他们以及他们所治疗的运动员有益。[《骨科》。2016年;39(5):e944 - e949。]

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