前列腺特异性抗原订单在实施治疗点提醒后,讨论查
Joshua J Fenton1, Daniel J Tancredi2
1From the Department of Family and Community Medicine, University of California, Davis, School of Medicine, Sacramento, CA (JJF); Center for Healthcare Policy and Research, University of California, Davis, School of Medicine, Sacramento, CA (JJF, DJT); and Department of Pediatrics, University of California, Davis, School of Medicine, Sacramento, CA (DJT). jjfenton@ucdavis.edu.
Journal of the American Board of Family Medicine : JABFM
|January 30, 2026
概括
电子医疗记录提醒在55-69岁的男性中显著增加前列腺特异抗原 (PSA) 查. 该提醒还导致其他年龄组的PSA订单增加,包括那些查益处不那么明显的年龄组.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 预防医学 预防医学
- 医疗信息学 医疗信息学
背景情况:
- 前列腺特异性抗原 (PSA) 查前列腺癌对55-69岁的男性有"C"的建议.
- 一个卫生系统在2023年1月实施了电子提醒,以促使临床医生讨论55-69岁男性的PSA查讨论.
研究的目的:
- 评估电子医疗记录 (EMR) 提醒对PSA订购率的影响.
- 评估实施后的目标和非目标年龄组的PSA订单趋势.
主要方法:
- 用中断时间序列分析来评估每月PSA订单率.
- 数据是从2022年1月到2024年7月收集的.
- 分析包括55-69岁 (目标) 和50-54岁,70-74岁和75岁以上 (非目标) 的男性.
主要成果:
- 在目标群体中,PSA订单显著增加 (访问中位数为6.4%至10.2%,IRR为1.57).
- 在非目标群体中,PSA的排序也增加了:50-54岁 (aIRR 1.44),70-74岁 (aIRR 1.26) 和≥75岁 (aIRR 1.11).
结论:
- 在预期的年龄组中,EMR提醒有效地增加了PSA订单.
- 这一提醒还导致在老年人群中增加了PSA订单,在那里查的好处可能不那么有利.
- 需要进一步评估所有年龄组增加PSA查的风险效益平衡.
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