A taxonomy of generic clinical questions: classification study
A taxonomy of generic clinical questions: classification study
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DOI：
10.1136/bmj.321.7258.429
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发表时间：
2000-08-12
影响因子：
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通讯作者：
Stavri, PZ
中科院分区：
文献类型：
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作者：
Ely, JW;Osheroff, JA;Stavri, PZ
目的建立医生关于病人护理问题的分类法，以帮助回答这些问题。设计利用俄勒冈州初级保健医生提出的295个问题来修改先前开发的爱荷华州家庭医生提出的1101个临床问题的分类法。设置爱荷华州和俄勒冈州的初级保健实践。参与者随机抽样103名爱荷华州家庭医生和49名俄勒冈州初级保健医生。主要结果衡量7名调查人员对普通问题的有意义的分类的共识；结果修订后的分类法包括通用问题类型，共对1 396个临床问题进行了分类。最常见的三种通用类型是“条件x的首选药物是什么？”(150个问题，占11%)；“症状x的原因是什么？”(115个问题，占8%)；以及“情况x需要做什么测试？”(112个问题，占8%)。11名编码员的平均评价员间信度为中等(kappa=0.53，一致性55%)。结论初级保健中的临床问题可以归类为有限的类属类型。本研究建立的分类法具有一定的信度，有助于加深我们对医生信息需求的了解，提高我们满足医生信息需求的能力。
Objective To develop a taxonomy of doctors' questions about patient care that could be used to help answer such questions.Design Use of 295 questions asked by Oregon primary care doctors to modify previously developed taxonomy of 1101 clinical questions asked by Iowa family doctors.Setting Primary care practices in Iowa and Oregon.Participants Random samples of 103 Iowa family doctors and 49 Oregon primary care doctors.Main outcome measures Consensus among seven investigators on a meaningful taxonomy of generic questions; interrater reliability among 11 individuals who used the taxonomy to classify a random sample of 100 questions: 50 from Iowa and 50 from Oregon.Results The revised taxonomy, which comprised 64 generic question types, was used to classify 1396 clinical questions. The three commonest generic types were "What is the drug of choice for condition x?" (150 questions, 11%); "What is the cause of symptom x?"(115 questions, 8%); and "What test is indicated in situation x?"(112 questions, 8%). The mean interrater reliability among 11 coders nas moderate (kappa = 0.53, agreement 55%).Conclusions Clinical questions in primary care can be categorised into a limited number of generic types. A moderate degree of interrater reliability was achieved with the taxonomy developed in this study, The taxonomy may enhance our understanding of doctors' information needs and improve our ability to meet those needs.