Sánchez Mollá M, Tovar J, Medina M A
Hospital y Centro de Especialidades, Elche.
Aten Primaria. 1994 May 15;13(8):446-8.
To assess the concordance between the diagnoses on referral from Primary Care to the Rheumatology Clinic and the final diagnoses made by the Rheumatologist.
Crossover study.
Rheumatology clinic in a specialist centre.
The study covered the first 308 patients referred consecutively from Primary Care by Family or General practitioners after the opening of the clinic in 1989.
A form for referring the patient to the Rheumatologist and filling in the basic data was composed. The referring doctor was also asked to classify the patient in one of five possible diagnostic categories. These diagnoses were compared with the opinion of the Rheumatologist.
The Family Doctor referred 105 patients and the General Practitioner, 203. The concordance between diagnoses as measured by the Kappa index was 0.61 (C.I. 0.81-0.41) for Family Doctors and 0.38 (C.I. 0.23-0.53) for General Practitioners.
The concordance of diagnoses between Family Doctors and Rheumatologists is good, whereas it was only regular/moderate for General Practitioners, which seems to indicate a superior objective training of Family Doctors in the diagnosis of these patients.
评估从初级保健机构转诊至风湿病诊所的诊断与风湿病专家做出的最终诊断之间的一致性。
交叉研究。
一家专科中心的风湿病诊所。
该研究涵盖了1989年诊所开业后由家庭医生或全科医生从初级保健机构连续转诊的前308名患者。
设计了一份将患者转诊给风湿病专家并填写基本数据的表格。还要求转诊医生将患者归类到五个可能的诊断类别之一。将这些诊断与风湿病专家的意见进行比较。
家庭医生转诊了105名患者，全科医生转诊了203名患者。以卡帕指数衡量的诊断一致性，家庭医生为0.61（置信区间0.81 - 0.41），全科医生为0.38（置信区间0.23 - 0.53）。
家庭医生与风湿病专家之间的诊断一致性良好，而全科医生的一致性仅为一般/中等，这似乎表明家庭医生在这些患者的诊断方面接受了更优质的客观培训。
