Parkerson G R
J Fam Pract. 1978 Aug;7(2):341-9.
Potential determinants of physician recognition and follow-up of abnormal laboratory values were studied in the ambulatory primary care setting. Data support the hypothesis that a significant positive association exists between the clinical importance of a laboratory result and physician response. Clinical importance was indicated by degree of abnormality of the laboratory value, the type of test, and the indication for obtaining the test. Response was not significantly associated with type of laboratory report or resident's year of training, but a relationship was shown with resident's National Board scores. A model of 12 laboratory tests was found to be more appropriate for studying recognition and follow-up than one of 30 because of fewer repetitious tests and fewer results of doubtful clinical usefulness. With such a select model, recognition and follow-up of abnormals can be used as process measures of quality of medical care.
在门诊初级保健环境中，对医生识别和跟进异常实验室检查结果的潜在决定因素进行了研究。数据支持这样一种假设，即实验室检查结果的临床重要性与医生的反应之间存在显著的正相关。临床重要性通过实验室检查值的异常程度、检查类型以及进行该检查的指征来体现。医生的反应与实验室报告类型或住院医师培训年份没有显著关联，但与住院医师的国家委员会考试成绩存在一定关系。由于重复性检查较少且临床实用性存疑的结果较少，发现一个包含12项实验室检查的模型比包含30项检查的模型更适合用于研究识别和跟进情况。借助这样一个精选模型，对异常情况的识别和跟进可作为医疗质量的过程指标。
