Springall R G, Todd I P
St Mark's Hospital, London.
J R Soc Med. 1988 Feb;81(2):87-8. doi: 10.1177/014107688808100211.
Of 500 consecutive patients with symptoms of colorectal disease referred to a specialist hospital for outpatient assessment, 305 were studied. There was a low incidence of examination by the general practitioner; less than half the patients had a rectal examination and 31% had no examination at all. In cases where GPs made a diagnosis, this was correct in half, which both demonstrates the potential for dangerous misdiagnosis and confirms the fact that many anorectal conditions can be identified by the history alone. It is suggested that direct-access clinics in a colorectal unit would minimize delay in accurate diagnosis. The resource implications for such a system would be limited in terms of special investigations and additional clinic facilities.
在被转诊至一家专科医院进行门诊评估的500例连续性结直肠疾病症状患者中，对305例进行了研究。全科医生的检查发生率较低；不到一半的患者接受了直肠检查，31%的患者根本没有接受检查。在全科医生做出诊断的病例中，仅有一半正确，这既表明了危险误诊的可能性，也证实了许多肛肠疾病仅凭病史即可确诊这一事实。建议在结直肠科设立直接就诊诊所，以尽量减少准确诊断的延误。就特殊检查和额外的诊所设施而言，这种系统对资源的影响将是有限的。
