心脏病专家在推荐冠状动脉造影方面的阈值是否高于家庭医生？
Do cardiologists have higher thresholds for recommending coronary arteriography than family physicians?
作者信息
Young M J, Fried L S, Eisenberg J, Hershey J, Williams S
机构信息
Medical College of Wisconsin, Milwaukee 53226.
出版信息
Health Serv Res. 1987 Dec;22(5):623-35.
Abstract
The purpose of this study was to use a new model of decision making to understand variability in physicians' utilization of diagnostic tests. We studied physicians' recommendations for coronary arteriography in hypothetical patients with chest pain by analyzing responses of 235 cardiologists and family physicians. Thresholds for testing were derived by obtaining estimates of the probability of disease and recommendations for coronary arteriography before and after an exercise test. We found that cardiologists compared with family practitioners had a significantly higher decision threshold and recommended coronary arteriography in fewer patients. These findings suggest that analyzing physicians' decision-making thresholds may be used to characterize differences in the practice behavior of groups of physicians.
摘要
本研究的目的是使用一种新的决策模型来理解医生在诊断测试使用上的差异。我们通过分析235名心脏病专家和家庭医生的回答，研究了他们对胸痛假想患者冠状动脉造影的建议。通过获取运动测试前后疾病概率的估计值以及冠状动脉造影的建议，得出了测试阈值。我们发现，与家庭医生相比，心脏病专家的决策阈值显著更高，且建议进行冠状动脉造影的患者更少。这些发现表明，分析医生的决策阈值可用于描述不同医生群体在实践行为上的差异。
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