患者和同行:指南设计和专家回应
Jane Greve1, Søren Rud Kristensen2, Nis Lydiksen3
1The Danish Center for Social Science Research, Herluf Trolles Gade 11, DK-1052, Copenhagen K, Denmark.
具有医疗专业知识的患者更有可能接受常见的,昂贵的治疗,如产前诊断测试 (PDT),即使不符合条件. 当偏差可能时,医学知识会影响遵守临床指南.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医学经济学 医学经济学
- 患者的坚持 患者的坚持
背景情况:
- 临床指导方针旨在标准化治疗,但遵守可能会有所不同.
- 患者因素,如医疗知识,可能会影响医疗保健决策.
- 产前诊断测试 (PDT) 是一种常见的,昂贵的程序,受指导方针的配给限制.
研究的目的:
- 调查患者医疗专业知识对遵守产前诊断测试 (PDT) 临床指南的影响.
- 为了确定医疗培训是否影响患者测试率,当资格门接近时.
主要方法:
- 对使用产前诊断测试 (PDT) 的行政数据的分析.
- 医学训练有素患者 (专家) 和非医学训练有素患者 (非专家) 之间的测试率的比较.
- 专注于临床指南的资格边缘附近的患者.
主要成果:
- 经过医学培训的患者在没有严格资格的情况下,比非专家接受PDT的可能性高9个百分点.
- 超过80%的测试率差异归因于患者的医学专业知识.
- 医学专业知识在临床指南的边界显著影响治疗决策.
结论:
- 临床指南的设计对于确保公平遵守至关重要.
- 患者的医学专业知识可能导致偏离临床指导方针,特别是在解释允许的情况下.
- 了解患者的专业知识对于优化指南实施和医疗保健准入至关重要.
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