目的:评估明尼苏达州初级保健医生(PCP)对肉瘤指南的熟悉程度。
方法:调查于2015年4月16日至17日和2015年10月24日在明尼苏达州举行的2次教育会议上进行。PCP被问到一系列有关其当前实践的问题,过去的肉瘤经验,熟悉肉瘤指南。然后为他们提供了一系列病例介绍,并要求他们指出是否会根据所提供的信息进行肉瘤检查。
结果:研究组包括80名医生和32名护士(NPs)。在他们的职业生涯中(中位数,14年),医生报告平均看到2.2例软组织肉瘤和0.7例骨肉瘤。NPs报告看到平均0.7和0.2例,恭敬地,在他们的职业生涯中(中位数,8年)。医生和NP均报告对肉瘤指南的熟悉程度较低。当遇到建议紧急转诊至肉瘤专家的病例报告时,超过50%的PCP表示他们不会转诊患者.有软组织肉瘤和骨肉瘤经验的PCP估计,只有17%和23%的患者,分别,在就诊后1个月内被诊断出。报告最多的延迟诊断原因是PCP建议患者“观察并等待”。“
结论:明尼苏达州PCP很少见肉瘤病例,并且报告对肉瘤指南的熟悉程度较低。当受到案例介绍的挑战时,PCP做出的决定不符合既定准则。这项研究支持正在进行的提高肉瘤意识的努力。
OBJECTIVE: To assess familiarity with sarcoma guidelines among primary care practitioners (PCPs) in Minnesota.
METHODS: Surveys were distributed at 2 educational conferences held in Minnesota on April 16-17, 2015, and October 24, 2015. The PCPs were asked a series of questions about their current practice, past experience with sarcoma, and familiarity with sarcoma guidelines. They were then given a series of case presentations and asked to indicate if they would pursue a sarcoma work-up given the information provided.
RESULTS: The study group included 80 physicians and 32 nurse practitioners (NPs). Over their careers (median, 14 years), physicians reported seeing a mean of 2.2 cases of soft tissue sarcoma and 0.7 cases of bone sarcoma. The NPs reported seeing a mean of 0.7 and 0.2 cases, respectfully, over their careers (median, 8 years). Both physicians and NPs reported low familiarity with sarcoma guidelines. When challenged with case presentations for which urgent referral to a sarcoma specialist is recommended, more than 50% of PCPs did not indicate that they would refer patients. The PCPs who had previous experience with soft tissue sarcoma and bone sarcoma estimated that only 17% and 23% of their patients, respectively, were diagnosed within 1 month of presentation. The most reported reason for a delayed diagnosis was the PCP advising the patient to \"watch and wait.\"
CONCLUSIONS: Minnesota PCPs have seen very few cases of sarcoma and report low familiarity with sarcoma guidelines. When challenged with case presentations, PCPs made decisions inconsistent with established guidelines. This study supports ongoing efforts to increase sarcoma awareness.