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牙损诊断和治疗中的不一致的决策:基于案例的问卷调查调查
Sofie Henneberg1, Julie Henriksen2, Lasse Christensen3
1Public Employed Dentist Kobenhavn Denmark.
Health science reports
|September 9, 2024
概括
牙医对牙损伤干预措施 (如密封和逐步挖掘) 达成的协议很薄弱,可能会危及患者的安全. 改善继续教育的机会对于基于证据的实践至关重要.
科学领域:
- 牙科 牙科是指牙科的专业.
- 牙科公共卫生 牙科公共卫生
- 临床实践指南 临床实践指南
背景情况:
- 延迟将新知识应用于临床实践,会给患者带来安全风险.
- 本研究调查了关于使用牙损伤干预措施的协议:密封和逐步挖掘.
研究的目的:
- 评估牙医之间关于牙损伤和脉的诊断和干预措施的评估者间的共识.
- 探索使用密封和逐步挖掘的变化,并确定影响这些决定的知识因素.
- 检查丹麦牙医对继续教育的态度与基于证据的实践有关.
主要方法:
- 在243名丹麦牙医中进行了横截面问卷调查.
- 该调查包括11个构建的临床病例,患者症状和诊断结果各不相同.
- 对诊断和干预措施的interrater协议使用Cohen和Light的kappa统计数据进行测量.
主要成果:
- 对于牙腐烂和脉诊断,观察到适度的interrater协议,但对干预措施的协议很弱.
- 对脏病诊断的黄金标准的同意程度中等,而对纸诊断的同意则不存在.
- 牙医报告的逐步挖掘的知识/使用与他们在临床病例中的实际选择之间存在差异;25%的人不熟悉密封,50%的人经常使用密封.
结论:
- 对干预措施达成的协议薄弱表明,一些患者可能会接受过于激进的治疗.
- 牙医认识到继续教育的重要性,但需要改善获得高质量,可信赖来源的机会和激励措施.
- 加强持续教育对于弥合基于证据的知识和临床实践之间的差距至关重要,改善患者安全.
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