CLINICIANS REASONS FOR OVERUSE OF SKULL RADIOGRAPHS
CLINICIANS REASONS FOR OVERUSE OF SKULL RADIOGRAPHS
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DOI：
10.2214/ajr.135.3.549
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发表时间：
1980-01-01
影响因子：
5
通讯作者：
CUMMINS, RO
中科院分区：
文献类型：
--
作者：
CUMMINS, RO
基于高收益适应症列表（HYL）的观察结果显示，80%的医生要求的创伤后颅骨X线片没有显示。为了调查这种可能的过度使用射线照相术，15名住院医师谁使用的HYL在大学急诊室进行了采访。访谈包括问卷调查、病例模拟和对实际头部创伤患者的讨论。过度使用的几个一般原因被检测如下：压倒性的适应症，以HYL;基本的解决问题的策略的医生（模式识别，方法的用尽，假设的生成和评估）;决策的背景（病人和家庭的期望，导师和同行的压力，医疗事故的威胁，时间管理的关注）;不确定性的恐惧;例程。过度使用放射诊断并非反常或不合理，而是由对手术收益的实际期望、个别医生的个人方法和决策环境中的压力等复杂因素造成的。
Observations based on a high yield indication list (HYL) revealed that 80% of posttraumatic skull radiographs requested by physicians were not indicated. To investigate this possible overuse of radiography, 15 resident physicians who used the HYL in a university emergency room were interviewed. The interviews included a questionnaire, case simulations and discussion of actual head trauma patients. Several general reasons for the overuse were detected as follows: overriding indications to the HYL; basic problem-solving strategies of the physicians (pattern recognition, method of exhaustion, and hypothesis generation and evaluation); context of the decision-making (patient and family expectations, mentor and peer pressure, malpractice threat, time management concerns); fear of uncertainty; routines. Overuse of diagnostic radiography was not perverse or irrational, but was produced by a complex mixture of actual expectation of yield from the procedure, personal approaches of the individual physicians and pressures in the decision-making environment.