Case History Questionnaires in the Study of Doctors' Use of Resources: Are They Measuring What We Want?
Case History Questionnaires in the Study of Doctors' Use of Resources: Are They Measuring What We Want?
复制标题
医生资源使用研究中的病例调查问卷：他们衡量的是我们想要的吗？
DOI：
10.1097/00005650-198510000-00005
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发表时间：
1985
期刊：
影响因子：
3
通讯作者：
C. Harris
中科院分区：
文献类型：
--
作者：
R. Hartley;J. Charlton;B. Jarman;C. Harris
一组15个自我管理的病历开发，每一个组成的一个简短的情况下，随后由一个标准的格式，所需的测试进行了检查。在对一组医生的病历进行初步测试后，作者选择了10个项目-总相关性最高的病例，这些病例也提供了广泛的临床谱。使用不同的一组19名医生，测试排序的问卷进行了比较，在临床实践中的实际测试排序。问卷测验排序并不能反映学生的练习行为，事实上，两者之间的关系呈负相关（r = -0.43，P < 0.10）。通过仅包括诊断与问卷调查病例相似的实践病例来调整病例组合变化并没有改善其性能（r = -0.50：P < 0.05）。这些研究结果表明，测试排序的情况下历史问卷可能无法反映实际的做法。关于考试排序行为和改变它的管理策略的结论不应该基于未经实际实践验证的问卷调查结果。
A set of 15 self-administered case histories were developed, each consisting of a short case followed by a standard format on which desired tests were checked. After pilot testing the case histories within a group of doctors, the authors selected the ten cases with the highest item-total correlations that also provided a broad clinical spectrum. Using a different group of 19 doctors, test-ordering on the questionnaire was compared with actual test-ordering in clinical practice. Questionnaire test-ordering did not reflect practice behavior; in fact, the relationship tended to be inverse (r = -0.43: P < 0.10). Adjusting for casemix variation by including only those practice cases with diagnoses similar to questionnaire cases did not improve its performance (r = -0.50: P < 0.05). These findings suggest that test-ordering on case history questionnaires may not reflect actual practice behavior. Conclusions about test-ordering behavior and management strategies to alter it should not be based on results from questionnaires that have not been validated against actual practice.