向初级保健医生进行临床报告可增加骨密度测定的使用和理解，并影响骨质疏松症的管理。一项随机试验。

Clinical reporting to primary care physicians leads to increased use and understanding of bone densitometry and affects the management of osteoporosis. A randomized trial.

作者信息

Stock J L, Waud C E, Coderre J A, Overdorf J H, Janikas J S, Heiniluoma K M, Morris M A

机构信息

Osteoporosis Research and Treatment Center, UMass Memorial Health Care, Worcester 01605, USA.

出版信息

Ann Intern Med. 1998 Jun 15;128(12 Pt 1):996-9. doi: 10.7326/0003-4819-128-12_part_1-199806150-00006.

DOI:10.7326/0003-4819-128-12_part_1-199806150-00006

PMID:9625686

Abstract

BACKGROUND

A major barrier to wider use of bone densitometry has been a lack of reports that are comprehensible to primary care physicians.

OBJECTIVE

To compare the effect of short technical reports and longer clinical reports on use, understanding, and acceptance of bone densitometry by primary care physicians and on management of osteoporosis.

DESIGN

Randomized trial.

SETTING

Osteoporosis center of a community teaching hospital.

SUBJECTS

57 primary care physicians ordering bone mineral density tests with dual x-ray absorptiometry.

INTERVENTION

Physicians were randomly assigned to receive short technical reports or long clinical reports written by endocrinologists with access to clinical information.

MEASUREMENTS

Physicians were interviewed by telephone after receiving at least two reports.

RESULTS

Before being interviewed, physicians receiving short reports ordered a mean +/- SD of 0.72 +/- 0.71 tests per month; those receiving long reports ordered 1.30 +/- 1.21 tests per month (P = 0.002). At the first interview, 30% of physicians receiving short reports and 86% of those receiving long reports understood the bone mineral density definition of osteoporosis (P < 0.001). Receiving long reports led to more modifications in the pharmacologic treatment of osteoporosis by gynecologists (19% of patients whose reports were short and 61% of patients whose reports were long; P = 0.021) and less confusion about reports by all physicians (36% of physicians receiving short reports and 1% of those receiving long reports; P = 0.003).

CONCLUSIONS

Clinical reporting of bone densitometry to primary care physicians increased use and understanding of bone densitometry, changed management of osteoporosis, and was well accepted. It may help achieve appropriate use of bone densitometry and may allow convenient dissemination of information on osteoporosis.

摘要

背景

骨密度测定法更广泛应用的一个主要障碍是缺乏初级保健医生能够理解的报告。

目的

比较简短的技术报告和较长的临床报告对初级保健医生使用、理解和接受骨密度测定法以及对骨质疏松症管理的影响。

设计

随机试验。

地点

社区教学医院的骨质疏松症中心。

研究对象

57名使用双能X线吸收法进行骨密度检测的初级保健医生。

干预措施

医生被随机分配接受由内分泌科医生撰写的简短技术报告或较长的临床报告，这些报告可获取临床信息。

测量方法

在医生收到至少两份报告后通过电话进行访谈。

结果

在接受访谈前，收到简短报告的医生每月平均订购0.72±0.71次检测；收到较长报告的医生每月订购1.30±1.21次检测（P = 0.002）。在第一次访谈时，收到简短报告的医生中有30%理解骨质疏松症的骨密度定义，而收到较长报告的医生中有86%理解（P < 0.001）。收到较长报告导致妇科医生对骨质疏松症的药物治疗做出更多调整（报告简短的患者中有19%，报告较长的患者中有61%；P = 0.021），并且所有医生对报告的困惑更少（收到简短报告的医生中有36%，收到较长报告的医生中有1%；P = 0.003）。