Uplekar M W, Antia N H, Dhumale P S
Foundation for Research in Community Health, Worli, Bombay.
BMJ. 1988 Oct 1;297(6652):841-3. doi: 10.1136/bmj.297.6652.841.
Sympmed I is an experimental computer program that identifies and offers treatment to outpatients whose symptoms can be effectively and safely treated. To verify the safety of using such a package an evaluation of Sympmed I was carried out. The patients' symptoms were entered into the computer by a junior doctor and then by a non-medical person, an engineer. The prescriptions offered by the program were compared with those given by a general practitioner after examining the patient. It was found that 390 of 500 (78%) patients in the first group and 276 of 400 (69%) patients in the second group were offered prescriptions comparable to the ones given by the general practitioner, and the rest were advised to see a doctor. In no case was a patient offered treatment when he or she needed to see a doctor. The results of the evaluation confirm that most problems seen by first level medical personnel in developing countries are simple, repetitive, and treatable at home or by a paramedical worker with a few safe, essential drugs, thus avoiding unnecessary visits to a doctor.
Sympmed I是一个实验性的计算机程序,它能够识别那些症状可得到有效且安全治疗的门诊病人并为其提供治疗。为了验证使用这样一个程序包的安全性,对Sympmed I进行了一次评估。病人的症状先由一名初级医生输入计算机,然后由一名非医学专业人员,一名工程师输入。在对病人进行检查后,将该程序提供的处方与一名全科医生给出的处方进行比较。结果发现,第一组500名病人中有390名(78%),第二组400名病人中有276名(69%)得到了与全科医生所开处方相当的处方,其余病人则被建议去看医生。在任何情况下,都不会给需要看医生的病人提供治疗。评估结果证实,发展中国家一级医务人员所遇到的大多数问题都很简单、重复,并且可以在家中或由辅助医务人员使用几种安全的基本药物进行治疗,从而避免不必要的就医。