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家庭医生的筛查实践:STFM和AAFP成员的比较。

Screening practices of family physicians: a comparison of STFM and AAFP members.

作者信息

Resnicow K, Schorow M, Bloom H G, Massad R, Coll-Barth M

机构信息

American Health Foundation, New York City.

出版信息

Fam Med. 1987 Sep-Oct;19(5):341-5.

PMID:3678672
Abstract

The screening practices of 146 members of the Society of Teachers of Family Medicine (STFM) and 129 members of the American Academy of Family Physicians (AAFP) are compared. The screening practices of physicians from the two organizations were generally similar for psychosocial and behavioral problems, many forms of cancer, and numerous other conditions considered for inclusion in the routine periodic screening of asymptomatic individuals. However, for numerous diseases and tests, the screening practices of physicians from the two groups were significantly different. AAFP physicians were more likely to screen for lung and skin cancer, thyroid dysfunction, diabetes, and anemia, AAFP physicians were more likely to utilize chest x-ray, ECG, urinalysis, and SMA 6/12. STFM physicians were more likely to perform gonoccocal culture and tetanus-diphtheria immunization as well as to inquire about seat belt use. Three variables were found to predict physician screening practices as well as to account for the differences found between physicians drawn from the two organizations: completion of a residency in family medicine, year of graduation from medical school, and number of patients seen per week. Physicians reported practices were compared with recommendations in the major critical reviews: Frame and Carlson, Breslow and Sommers, the Canadian Task Force, and the American Cancer Society. For a number of tests and diseases physicians' reported practices were divergent with recent recommendations.

摘要

对美国家庭医学教师协会(STFM)的146名成员和美国全科医师学会(AAFP)的129名成员的筛查实践进行了比较。对于社会心理和行为问题、多种癌症形式以及许多其他考虑纳入无症状个体常规定期筛查的疾病,两个组织的医生的筛查实践总体相似。然而,对于许多疾病和检查,两组医生的筛查实践存在显著差异。AAFP的医生更有可能筛查肺癌、皮肤癌、甲状腺功能障碍、糖尿病和贫血,AAFP的医生更有可能使用胸部X光、心电图、尿液分析和SMA 6/12。STFM的医生更有可能进行淋球菌培养和破伤风-白喉免疫接种,以及询问安全带使用情况。发现有三个变量可以预测医生的筛查实践,并解释两个组织的医生之间存在的差异:完成家庭医学住院医师培训、医学院毕业年份以及每周看诊的患者数量。将医生报告的实践与主要批判性综述中的建议进行了比较:Frame和Carlson、Breslow和Sommers、加拿大工作组以及美国癌症协会。对于一些检查和疾病,医生报告的实践与近期建议存在分歧。

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