Epidemiology of endometriosis.
Epidemiology of endometriosis.
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DOI：
10.1136/bmj.306.6877.585-d
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发表时间：
1993-02
影响因子：
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通讯作者：
A. Prentice
中科院分区：
文献类型：
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作者：
A. Prentice
编辑：皇家放射科医生工作组报告的这项研究的设计似乎存在缺陷。使用一项不受控制的研究报告在准则出台后的一年内从一般做法转诊的人数减少，然后将这种下降归因于准则本身，这有点天真。需要设立一个对照小组，以排除导致所报告的转诊率下降的长期趋势。这很可能是我们在没有与当地全科医生进行教育或交流的地区采取的一系列做法。这样的对照小组也很容易确定，因为自1990年4月采用新合同以来，所有做法都保留了转介进行X光检查的记录。我们的做法显示，在过去两个完整的年报年度，即1990-1年度和1991-2年度，每1000名病人转介X光检查的个案减少了14宗。如果这种行为代表了一种全国性的趋势，那么这些指导方针对样本医生行为的影响可能并不像研究表明的那样明显。
EDITOR,-The design of the study reported by the Royal College of Radiologists Working Party' seems flawed. Using an uncontrolled study to report a reduction in referrals from general practice in the year after introduction of the guidelines and then to ascribe this drop to the guidelines themselves is somewhat naive. A control group is needed to exclude a secular trend contributing to the reported reduction in referral rates. This could easily have been a series of practices such as our own in areas where no education or communication with the local general practitioners took place. Such a control group could also have been identified easily as all practices have been keeping records of their referrals for x ray examinations since the introduction of the new contract in April 1990. Our practice shows a reduction in referrals for x ray examinations of 14 per 1000 patients between the last two full annual report years of 1990-1 and 1991-2. If this behaviour represents a national trend then the influence of these guidelines on the sample doctors' behaviour may not have been as pronounced as the study suggests.