Fossum Croix C, Breen William G, Sun Philip Y, Retzlaff Amber A, Okuno Scott H
Mayo Clinic Alix School of Medicine, Rochester, MN.
University of Minnesota Medical School, Minneapolis.
Mayo Clin Proc Innov Qual Outcomes. 2020 Mar 18;4(2):143-149. doi: 10.1016/j.mayocpiqo.2019.12.002. eCollection 2020 Apr.
To assess familiarity with sarcoma guidelines among primary care practitioners (PCPs) in Minnesota.
Surveys were distributed at 2 educational conferences held in Minnesota on April 16-17, 2015, and October 24, 2015. The PCPs were asked a series of questions about their current practice, past experience with sarcoma, and familiarity with sarcoma guidelines. They were then given a series of case presentations and asked to indicate if they would pursue a sarcoma work-up given the information provided.
The study group included 80 physicians and 32 nurse practitioners (NPs). Over their careers (median, 14 years), physicians reported seeing a mean of 2.2 cases of soft tissue sarcoma and 0.7 cases of bone sarcoma. The NPs reported seeing a mean of 0.7 and 0.2 cases, respectfully, over their careers (median, 8 years). Both physicians and NPs reported low familiarity with sarcoma guidelines. When challenged with case presentations for which urgent referral to a sarcoma specialist is recommended, more than 50% of PCPs did not indicate that they would refer patients. The PCPs who had previous experience with soft tissue sarcoma and bone sarcoma estimated that only 17% and 23% of their patients, respectively, were diagnosed within 1 month of presentation. The most reported reason for a delayed diagnosis was the PCP advising the patient to "watch and wait."
Minnesota PCPs have seen very few cases of sarcoma and report low familiarity with sarcoma guidelines. When challenged with case presentations, PCPs made decisions inconsistent with established guidelines. This study supports ongoing efforts to increase sarcoma awareness.
评估明尼苏达州初级保健医生（PCP）对肉瘤指南的熟悉程度。
在2015年4月16 - 17日以及2015年10月24日于明尼苏达州举行的2次教育会议上分发了调查问卷。向初级保健医生询问了一系列关于他们当前的医疗实践、过去处理肉瘤的经验以及对肉瘤指南的熟悉程度的问题。然后给他们提供一系列病例报告，并要求他们根据所提供的信息表明是否会进行肉瘤检查。
研究组包括80名医生和32名执业护士（NP）。在他们的职业生涯中（中位数为14年），医生报告平均见过2.2例软组织肉瘤和0.7例骨肉瘤。执业护士报告在他们的职业生涯中（中位数为8年）平均分别见过0.7例和0.2例。医生和执业护士均报告对肉瘤指南的熟悉程度较低。当面对建议紧急转诊至肉瘤专科医生的病例报告时，超过50%的初级保健医生未表明他们会转诊患者。有软组织肉瘤和骨肉瘤既往经验的初级保健医生估计，他们的患者中分别只有17%和23%在就诊后1个月内被诊断出来。报告的诊断延迟的最主要原因是初级保健医生建议患者“观察并等待”。
明尼苏达州的初级保健医生见过的肉瘤病例极少，且报告对肉瘤指南的熟悉程度较低。面对病例报告时，初级保健医生做出的决策与既定指南不一致。本研究支持为提高对肉瘤的认识而持续做出的努力。
