Feasibility of an ultrasound service on district health care level in Botswana
Feasibility of an ultrasound service on district health care level in Botswana
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DOI：
10.1046/j.1365-3156.2001.00807.x
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发表时间：
2001-12-01
影响因子：
3.3
通讯作者：
Troeger, J
中科院分区：
文献类型：
--
作者：
Bussmann, H;Koen, E;Troeger, J
目的评估超声服务在博茨瓦纳地区医院的临床效益和财政可行性。方法超声服务建立在研究医院。临床和超声辅助诊断进行了比较，在符合资格标准的患者中规定的适应症list.Results我们招募了2309例患者超过18个月。最常见的超声适应症是妊娠相关诊断，其次是妇科和肝胆疾病。超声辅助改善了696例（30%）病例的管理，并导致151例患者的管理立即改变。以超声诊断为金标准，评价临床诊断不全流产的准确性（灵敏度24%;阳性预测值，PPV 66%），盆腔肿块（敏感性53%; PPV 69%），异位妊娠（敏感性75%; PPV 28%）和胆囊结石结论：超声改善了地区卫生保健水平上遇到的各种临床问题的病例管理。这项服务证明是博茨瓦纳保健系统负担得起的。
OBJECTIVE To assess the clinical benefit and financial feasibility of an ultrasound service in a district hospital in Botswana.METHOD An ultrasound service was established in the study hospital. Clinical and ultrasound-aided diagnoses were compared in patients who met eligibility criteria laid down in an indication list.RESULTS We enrolled 2309 patients over 18 months. The most frequent indications for ultrasound were pregnancy-related diagnoses followed by gynaecological and hepato-biliary disorders. Ultrasound assistance improved case management in 696 cases (30%) and led to an immediate change in management in 151 patients. Ultrasound diagnosis was used as gold standard to assess the accuracy of the clinical diagnosis of incomplete abortion (sensitivity 24%; positive predictive value, PPV 66%), pelvic mass (sensitivity 53%; PPV 69%), ectopic pregnancy (sensitivity 75%; PPV 28%), and gall bladder stones (sensitivity 30%; PPV 32%).CONCLUSIONS Ultrasound improved case management for a wide diversity of clinical problems encountered on district health care level. The service proved to be affordable for the Botswana health care system.