Mamon J, Green L, Levine D M, Gibson G, Gurley H T
Department of Behavioral Sciences and Health Education, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205.
Med Care. 1987 Aug;25(8):770-80. doi: 10.1097/00005650-198708000-00010.
This study describes the development and testing of a high blood pressure protocol for use in emergency departments (ED) to enhance detection of those patients appropriate for subsequent referral. The protocol involves two serial blood pressure measurements and a patient interview to determine: 1) previous history of high blood pressure (HBP), 2) treatment in past year for HBP, and 3) usual source of medical care. The accuracy of patient reporting was validated by comparison with the patients' hospital record (reflecting outpatient and inpatient visits). Results indicate that these self-reports have high levels of sensitivity (range 90-100%) and specificity (range 79-96%). Use of the additional patient information increased the sensitivity of the screening protocol in identifying when and where a patient should be referred. Use of this methodology indicates that the protocol is a simple and effective method for HBP screening. The findings also suggest that the ED is an ideal site for screening the "hard-to-reach" hypertensive population.
本研究描述了一种用于急诊科（ED）的高血压诊疗方案的制定与测试，该方案旨在提高对适合后续转诊患者的检测率。该方案包括两次连续的血压测量以及一次患者访谈，以确定：1）高血压（HBP）既往史，2）过去一年中针对HBP的治疗情况，以及3）通常的医疗保健来源。通过与患者的医院记录（反映门诊和住院就诊情况）进行比较，验证了患者报告的准确性。结果表明，这些自我报告具有较高的敏感性（范围为90 - 100%）和特异性（范围为79 - 96%）。使用额外的患者信息提高了筛查方案在确定患者应何时何地转诊方面的敏感性。使用这种方法表明该方案是一种简单有效的HBP筛查方法。研究结果还表明，急诊科是筛查“难以触及”的高血压人群的理想场所。
