Wagner E H, Williams C A, Greenberg R, Kleinbaum D, Wolf S, Ibrahim M A
Am J Public Health. 1978 May;68(5):464-70. doi: 10.2105/ajph.68.5.464.
This study tests a questionnaire method for eliciting process criteria for medical care appraisal. The questionnaire was sent to national samples of family physicians, pediatricians, and pediatricians specializing in infectious diseases asking their opinions about various clinical actions in 125 clinical situations concerning respiratory infection in infants. Five hundred twenty-four (54%) physicians returned completed questionnaires. Questionnaire responses favored the performance of a majority of actions and opposed very few. Opinions concerning individual actions, particularly diagnostic tests and treatments, varied widely depending upon the clinical situation presented. A second questionnaire sent one year later indicated that the opinions expressed in the first questionnaire remained stable over time, especially if the initial opinion favored performance of the action. Comparison of the questionnaire responses and medical records of a group of practitioners demonstrated that only 55% of actions favored in a practitioner's questionnaire appeared in his records. Although the questionnaire method appears to be a feasible, specific, and reliable means of identifying clinical opinion, there remains considerable discordance between opinion as expressed in the questionnaire and recorded clinical practice.
本研究测试了一种用于引出医疗保健评估过程标准的问卷调查方法。该问卷被发送给家庭医生、儿科医生以及专门从事传染病的儿科医生的全国样本，询问他们对125种关于婴儿呼吸道感染临床情况中各种临床行为的看法。524名（54%）医生返回了完整的问卷。问卷回复支持大多数行为，反对的很少。关于个别行为，特别是诊断测试和治疗的意见，因所呈现的临床情况而异。一年后发送的第二份问卷表明，第一份问卷中表达的意见随时间保持稳定，特别是如果最初的意见支持该行为的实施。对一组从业者的问卷回复和医疗记录进行比较表明，从业者问卷中支持的行为只有55%出现在其记录中。尽管问卷调查方法似乎是一种可行、具体且可靠的确定临床意见的方法，但问卷中表达的意见与记录的临床实践之间仍存在相当大的不一致。
