Can non-physician health-care workers assess and manage cardiovascular risk in primary care?
Can non-physician health-care workers assess and manage cardiovascular risk in primary care?
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DOI：
10.2471/blt.06.032177
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发表时间：
2007-06-01
期刊：
影响因子：
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通讯作者：
Mendis, Shanthi
中科院分区：
文献类型：
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作者：
Abegunde, Dele O;Shengelia, Bakuti;Mendis, Shanthi
目的 确定非医师卫生保健工作者 (NPHW) 在典型的初级卫生保健环境中应用世界卫生组织心血管风险管理包的可靠性。 方法 基于 NPHW 和“专家”医师之间先验 80% 的一致性水平（金标准），获得了 649 个配对（匹配）的方案应用，并使用 Kappa 统计和多元 Logit 回归进行分析。结果表明超过评估者之间的一致性达到 80%，包中几乎所有部分的一致性程度从中等到完美。评估者与基准之间出现差异的几率并不具有统计显着性。 结论 应用世界卫生组织心血管风险管理一揽子计划，可以对 NPHW 进行再培训，以便在没有主治医生的初级卫生保健机构中可靠、有效地评估和管理心血管风险。该一揽子计划可能成为扩大初级卫生保健中心血管疾病管理的有用工具。
Objective To ascertain the reliability of applying the WHO Cardiovascular Risk Management Package by non-physician health-care workers (NPHWs) in typical primary health-care settings.Methods Based on an a priori 80% agreement level between the NPHWs and the "expert" physicians (gold standard), 649 paired (matched) applications of the protocol were obtained for analysis using Kappa statistic and multivariate logit regression.Findings Results indicate over 80% agreement between raters, from moderate to perfect levels of agreement in almost all of the sections in the package. The odds of obtaining a difference between raters and a benchmark are not statistically significant.Conclusion Applying the WHO Cardiovascular Risk Management Package, NPHWs can be retrained to reliably and effectively assess and manage cardiovascular risks in primary health-care settings where there are no attending physicians. The package could be a useful tool for scaling up the management of cardiovascular diseases in primary health care.