摄入查问卷的精度降低与质量指标相关
Jodi Simon1, Jeffrey Panzer2,3, Katherine M Wright4
1AllianceChicago, Chicago, Illinois jsimon@alliancechicago.org.
Annals of family medicine
|September 25, 2023
概括
使用PHQ-2和GAD-2工具进行临床抑郁和焦虑查可能是无效的. 超过91%的查显示可能性低,不同于预期的结果,可能浪费临床资源.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床信息学 临床信息学
- 心理健康查 心理健康查
背景情况:
- 临床工作流程往往优先考虑患者摄入查的性能指标.
- 在现实环境中,例行心理健康查的有效性需要评估.
- 两项患者健康问卷 (PHQ-2) 和泛性焦虑障碍2 (GAD-2) 是常见的查工具.
研究的目的:
- 评估PHQ-2和GAD-2查在联邦合格卫生中心的有效性和准确性.
- 评估与绩效指标相关的基于访问的选是否产生预期的价值.
- 识别当前查实践的潜在意外后果.
主要方法:
- 电子健康记录数据的回顾性分析.
- 2019年至2021年间从24个联邦合格卫生中心收集的数据.
- 检查了PHQ-2用于抑郁症和GAD-2用于焦虑查的结果.
主要成果:
- 超过91%的PHQ-2和GAD-2测试表明抑郁或焦虑的可能性很低.
- 观察到的查结果与已发表的文献有很大差异.
- 查结果表明,低风险病例的潜在过度识别.
结论:
- 与绩效指标相关的基于访问的心理健康查在实践中可能不有效.
- 目前的查协议有可能误导临床工作从更高价值的活动.
- 重新考虑常规查策略是必要的,以确保临床价值和患者的好处.
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