心力衰竭患者纽约心脏协会（NYHA）心功能分级的提供者评定：一项病例 vignette 研究。 （注：vignette 在这里可译为“病例 vignette”，指一种简短的病例描述等，具体含义可根据上下文进一步确定准确译法）
Providers' assignment of NYHA functional class in patients with heart failure: A vignette study.
作者信息
Stamp Kelly D, Prasun Marilyn A, McCoy Thomas P, Rathman Lisa
机构信息
Professor & Chair, Family & Community Nursing Department, Eloise R. Lewis Excellence Professor, UNC Greensboro, School of Nursing, 264 Nursing Instructional Building, Greensboro, North Carolina, 27402-6170, USA.
Carle BroMenn Medical Center Endowed Professor, Illinois State University, Mennonite College of Nursing, Normal, Illinois, USA.
出版信息
Heart Lung. 2022 Jan-Feb;51:87-93. doi: 10.1016/j.hrtlng.2021.07.009. Epub 2021 Aug 14.
BACKGROUND
Accuracy of New York Heart Association Functional Classification (NYHA-FC) I-IV assessment is critical to promoting guideline directed care.
OBJECTIVE
Examine providers' accuracy when diagnosing NYHA-FC I-IV in patients with heart failure (HF).
METHODS
A web-based survey using validated vignettes was conducted with 244 physicians, nurse practitioners (NP), clinical nurse specialists (CNS) and physician assistants (PA) who provide care to patients with HF.
RESULTS
Providers comprised of 65% NPs, 19% physicians, 14% CNSs, 2% PAs with an average of 15 years working with HF patients. Accuracy ranged from 36.9% for Class IV to 78.7% for Class I. Increased HF patient volume seen (p=0.024), physician vs. NP/PA/CNS (p=0.021), and typically assigned a HF stage (p<0.001) were associated with increased total correct score accuracy in multivariable modeling.
CONCLUSION
It is critical that NYHA-FC is accurately assigned to promote optimal outcomes. Research in the future should focus on improving accuracy in assigning NYHA-FC.
背景
纽约心脏协会功能分级（NYHA - FC）I - IV级评估的准确性对于促进指南指导下的治疗至关重要。
目的
检查医疗服务提供者在诊断心力衰竭（HF）患者NYHA - FC I - IV级时的准确性。
方法
对244名治疗HF患者的医生、执业护士（NP）、临床护理专家（CNS）和医师助理（PA）进行了一项基于网络的调查，调查使用了经过验证的病例 vignettes。
结果
医疗服务提供者中65%为NP，19%为医生，14%为CNS，2%为PA，平均有15年治疗HF患者的经验。准确性范围从IV级的36.9%到I级的78.7%。在多变量建模中，更高的HF患者量（p = 0.024）、医生与NP/PA/CNS（p = 0.021）以及通常分配的HF阶段（p < 0.001）与总正确评分准确性的提高相关。
结论
准确分配NYHA - FC对于促进最佳治疗效果至关重要。未来的研究应专注于提高NYHA - FC分配的准确性。
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