诊断数据的解读：全科医疗中一个未被探索的领域。
Interpretation of diagnostic data: an unexplored field in general practice.
作者信息
Knottnerus J A
出版信息
J R Coll Gen Pract. 1985 Jun;35(275):270-4.
Abstract
In interpreting diagnostic information the differences between morbidity patterns in general practice and those in hospitals must be taken into consideration. This article demonstrates the importance of prevalence for predictive values of complaints, symptoms and test results. When the general practitioner refers patients to the specialist, these values may change, and it is also possible that associations between symptoms and diagnoses are distorted by selection bias. Moreover, attention must be paid to the differences in clinical stages encountered in general practice and specialist practice. It is concluded that a large part of the ;diagnostic field' of general practice has still to be discovered and developed.
摘要
在解读诊断信息时，必须考虑到全科医疗和医院发病模式之间的差异。本文阐述了患病率对于主诉、症状及检查结果预测值的重要性。当全科医生将患者转诊给专科医生时，这些值可能会发生变化，而且症状与诊断之间的关联也可能因选择偏倚而被扭曲。此外，还必须注意全科医疗和专科医疗中所遇到的临床阶段的差异。结论是，全科医疗的“诊断领域”很大一部分仍有待探索和发展。
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本文引用的文献
1
[The sensitivity, specificity and predictive value of diagnostic tests].
Ned Tijdschr Geneeskd. 1983 Mar 26;127(13):556-61.
2
Symptoms and circulating haemoglobin level.
J Chronic Dis. 1969 Feb;21(9):615-28. doi: 10.1016/0021-9681(69)90034-4.
3
[Practical value of mammography for the surgeon].
Ned Tijdschr Geneeskd. 1970 Oct 10;114(41):1688-90.
4
The normal haemoglobin level.
Br J Haematol. 1970 Oct;19(4):429-34. doi: 10.1111/j.1365-2141.1970.tb06970.x.
5
The estimation of haemoglobin and the diagnosis of anaemia in general practice.
Practitioner. 1972 Aug;209(250):218-22.
6
[Is there room for individual iodine supplementation as prevention for goiter?].
Ned Tijdschr Geneeskd. 1977 Jun 4;121(23):955-6.
7
[The occult breast carcinoma].
Ned Tijdschr Geneeskd. 1977 Mar 26;121(13):526-9.
8
Problems of spectrum and bias in evaluating the efficacy of diagnostic tests.
N Engl J Med. 1978 Oct 26;299(17):926-30. doi: 10.1056/NEJM197810262991705.
9
Acute abdominal pain--an O.M.G.E. survey.
Scand J Gastroenterol Suppl. 1979;56:29-43.
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