Hutchison B, Birch S, Evans C E, Goldsmith L J, Markham B A, Frank J, Paterson M
Department of Family Medicine, Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.
J Clin Epidemiol. 1998 Oct;51(10):817-25. doi: 10.1016/s0895-4356(98)00068-7.
To assess the performance of selective opportunistic screening in a primary care group practice.
Cross-sectional survey of coronary heart disease risk factors and retrospective chart audit of cholesterol testing.
Capitation-funded primary care group practice in Ontario, Canada.
7785 enrolled patients between the ages of 20 and 69 years.
Protocol-based selective opportunistic screening program for hypercholesterolemia of 45 months duration.
Targeting (proportion of screening tests that were appropriate), coverage (proportion of those meeting screening criteria who had a screening test performed), over-screening (proportion of those not meeting screening criteria who had a screening test performed), and screening ratio (likelihood that a screening test was performed on an individual who met screening criteria rather than one who failed to meet screening criteria).
64.7% of patients tested met the practice criteria for screening. 37.7% of patients who met the practice screening criteria were tested and 24.9% of those not meeting practice screening criteria had a cholesterol test performed. The screening ratio was 1.52.
Our findings bring into question the effectiveness of opportunistic approaches to preventive care.
评估在基层医疗团体诊所进行选择性机会性筛查的效果。
对冠心病危险因素进行横断面调查，并对胆固醇检测进行回顾性病历审核。
加拿大安大略省按人头付费的基层医疗团体诊所。
7785名年龄在20至69岁之间的登记患者。
基于方案的为期45个月的高胆固醇血症选择性机会性筛查项目。
针对性（合适的筛查检测比例）、覆盖率（符合筛查标准且接受了筛查检测的比例）、过度筛查（不符合筛查标准但接受了筛查检测的比例）以及筛查比率（对符合筛查标准的个体而非不符合筛查标准的个体进行筛查检测的可能性）。
64.7%接受检测的患者符合诊所的筛查标准。37.7%符合诊所筛查标准的患者接受了检测，24.9%不符合诊所筛查标准的患者进行了胆固醇检测。筛查比率为1.52。
我们的研究结果对机会性预防保健方法的有效性提出了质疑。
