THE PATIENT RECORD IN EPIDEMIOLOGY
THE PATIENT RECORD IN EPIDEMIOLOGY
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DOI：
10.1038/scientificamerican1081-54
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发表时间：
1981-01-01
影响因子：
3
通讯作者：
MOLGAARD, CA
中科院分区：
文献类型：
--
作者：
KURLAND, LT;MOLGAARD, CA
保留脐带是医疗实践的一部分，其全部效用并不容易被理解。保持所有诊断，药物，实验室程序和每个病人的其他信息的最新记录有助于确保医疗护理的连续性，从而有助于个人病人的福利，它可能看起来不太可能，但是，病人记录本身可能有助于医学知识的进步。实际上，一份作为例行程序编写的病历可以有更大的用途。特别是许多患者的历史记录的收集是临床护理和流行病学进步的宝贵资源：调查人口中的健康和疾病模式。在明尼苏达州罗切斯特的马约诊所，有一个大型的医疗档案馆，它的价值得到了充分的证明。这些记录按诊断和病人的特征进行索引。档案馆的信息已被用于确定多种疾病的发病率，包括多发性硬化症、帕金森综合征、中风、白血病和几乎所有其他形式的癌症。1976年12月的一个事件说明了档案馆的能力。当公共卫生服务部门的医生注意到接种疫苗的人中似乎有相当多的格林-巴利综合征病例时，一项针对“猪流感”流感病毒株的全国免疫计划被暂停。为了确定多少病例构成一个相对较大的数字，有必要知道该疾病的基线发病率：
Rcord keeping is a part of medical practice whose full utility is not readily appreciated. Maintaining a current record of all diagnoses, medi cations, laboratory procedures and oth er information for each patient helps to ensure the continuity of medical care and thereby contributes to the welfare of the individual patient; it may seem unlikely, however, that the patient rec ord itself could contribute much to the advance of medical knowledge. Actual ly a patient record compiled as a matter of routine can serve a larger purpose. In particular a historical collection of the records of many patients is an invalu able resource for advances in clinical care and for epidemiology: the investi gation of patterns of health and disease in a population. One such collection that has amply proved its worth is a large archive of medical records at the Mayo Clinic in Rochester, M inn. The records are indexed by diagnosis and by demo graphic characteristics of the patients. Information from the archive has been employed in determining the incidence of a wide range of diseases, including mUltiple sclerosis, parkinsonism, stroke, leukemia and almost every other form of cancer.An incident in December, 1976, il lustrates the capabilities of the archive. A national program of imm unization against the" swine flu" strain of influen za was suspended when Public Health Service physicians noted among those who had been inoculated what seemed to be a relatively large number of cases of Guillain-Barre syndrome, a rare neu romuscular disorder. In order to define how many cases constitute a relatively large number it was necessary to know the base-line incidence of the disease: the incidence in the population as a