家庭医生高估了诊断的概率,无论测试结果如何
Ömer Ataç1,2, Hüseyin Küçükali3,4, Ayşe Zülal Tokaç Farımaz3
1Department of Public Health, International School of Medicine, Istanbul Medipol University, Istanbul, Türkiye.
Frontiers in medicine
|January 23, 2024
概括
初级保健医生一直高估了常见疾病的疾病概率,表明需要加强基于证据的决策. 这影响了诊断测试的解释和患者的护理.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 初级医疗保健医学 一级医疗保健医学
- 临床决策 - 临床决策
背景情况:
- 诊断测试对于临床决策至关重要,但需要准确的解释.
- 误解可能导致诊断不足,过度诊断或误诊.
- 了解医生对诊断概率的解释是必不可少的.
研究的目的:
- 探索初级保健医生在诊断测试结果之前和之后对疾病概率的理解和解释.
- 在常见的癌症查和传染病情景中评估解释准确性.
主要方法:
- 一项涉及伊斯坦布尔414名家庭医生的横截面研究.
- 面对面的采访评估六种临床情景的概率估计 (乳腺癌,宫癌,结直肠癌;肺炎,尿道感染,COVID-19).
- 估计结果与从临床指南中得出的真实概率进行了比较.
主要成果:
- 在所有情景中,医生的概率估计明显高于科学证据.
- 在测试前的概率和在阳性和阴性测试结果后都注意到过高估计.
- 在对照问题中,测试准确度的估计明显不准确 (95%与2%为阳性,5%与0%为阴性).
结论:
- 过高估计表明家庭医生实践中可能缺乏概率方法.
- 加强基于证据的决策能力对于防止误解诊断测试至关重要.
- 准确的解释是必要的,以避免错误或不必要的治疗和不良结果.
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