全科医生在结核病诊断方面的专业水平

M. Jakimova, V. Punga, O. Komissarova
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摘要

背景:全科医生(gp)在结核病诊断中的错误导致俄罗斯联邦人口中出现严重、慢性、危险的流行病学形式的结核病。材料和方法:培训中心对312名全科医生进行了单步在线测试,以评估他们对结核病检测诊断标准的了解程度。该测试包含27个问题,涉及患者的主诉、病史、临床表现和转诊到专门的结核病机构所需的检查。结果:只有31.6%的正确评估患者病情的医生报告了高水平的知识(85%或更多的正确答案),从而导致发展为严重形式结核病的可能性较低。42.3%的全科医生在结核病及其诊断知识方面存在一定差距,并且在实践中没有使用对疑似肺结核患者的评估算法,这些全科医生的知识水平很差——不到正确答案的30%。全科医生在结核病诊断方面的培训不足对该国的流行病学情况产生了影响。这组医生被邀请参加一个特殊的20小时培训项目(网络研讨会)框架下的主题课程。培训结果将在6个月内进行评估和报告。结论:有必要将现代结核病诊断方法的系统培训作为医科大学课程和生理学高级培训课程的一部分。
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Level of expertise in TB diagnosis among general practitioners
Background: Errors in TB diagnosis made by the general practitioners (GPs) lead to the development of severe, chronic, dangerous epidemiological forms of the disease among the population of the Russian Federation. Material and Methods: The training center performed a single-step online testing of 312 GPs to assess their knowledge of diagnostic criteria for TB detection. The test contained 27 questions regarding patient complaints, history, clinical manifestations and tests required for a referral to a specialized TB facility Results: A high level of knowledge (85% or more correct answers) was reported only in 31.6% of physicians who correctly evaluated patient conditions resulting in a low probability of developing severe forms of tuberculosis. Poor level of knowledge - less than 30% of correct answers - was observed in 42.3% of GPs who had some gaps in knowledge about tuberculosis and its diagnostics and did not use the evaluation algorithms for patients with presumed pulmonary TB in their practice. Poor training of GPs in TB diagnosis has an impact on the epidemiological situation in the country. This group of physicians was invited to take a thematic course in the framework of a special 20-hour training program (webinar). The training outcomes will be evaluated and reported in 6 months. Conclusions: There is a need for systematic training in modern approaches to TB diagnosis as part of the curriculum of the Medical universities and advanced training courses in phthisiology.
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