中国全科医学 ›› 2021, Vol. 24 ›› Issue (22): 2843-2849.DOI: 10.12114/j.issn.1007-9572.2021.00.150

所属专题: 社区卫生服务最新研究合集 指南/共识最新文章合集

• 专题研究 • 上一篇    下一篇

《社区全科医生使用便携式超声技术探查甲状腺及颈动脉服务规范》的AGREE工具评价结果与应用建议

宋烨1,赵峰2,陈明3*,张韬4*   

  1. 1.201318上海市浦东新区周浦医院超声科 2.201300上海市浦东新区光明中医医院超声科 3.200120上海市,同济大学附属东方医院超声科 4.200136上海市浦东新区金杨社区卫生服务中心
    *通信作者:陈明,主任医师,硕士生导师;E-mail:mingchen1283@vip.163.com 张韬,主任医师;E-mail:jysqzhangtao@126.com
  • 出版日期:2021-08-05 发布日期:2021-08-05
  • 基金资助:
    浦东新区卫生系统领先人才培养计划(PWRl2017-05);上海市卫生健康委员会科研课题(202040022)

Specifications for Community General Practitioners to Screen for Thyroid and Carotid Diseases Using the Portable Ultrasound Device:Quality Evaluation Using AGREEⅡ and Recommendations 

SONG Ye1,ZHAO Feng2,CHEN Ming3*,ZHANG Tao4*   

  1. 1.Department of Ultrasound,Shanghai Pudong New District Zhoupu Hospital,Shanghai 201318,China
    2.Department of Ultrasound,Pudong New Area Guangming Hospital of Traditional Chinese Medicine,Shanghai 201300,China
    3.Department of Ultrasound,Dongfang Hospital Affiliated to Tongji University,Shanghai 200120,China
    4.Pudong New Area Jinyang Community Health Center,Shanghai 200136,China
    *Corresponding authors:CHEN Ming,Chief physician,Master supervisor;E-mail:mingchen1283@vip.163.com
    ZHANG Tao,Chief physician;E-mail:jysqzhangtao@126.com
  • Published:2021-08-05 Online:2021-08-05

摘要: 背景 为了让社区全科医生高效高质量地掌握使用便携式超声技术进行甲状腺和颈动脉的初步超声探查技术,开发了社区全科医生使用便携式超声技术探查甲状腺及颈动脉服务规范。目的 选择临床指南研究与评价工具(AGREEⅡ)对服务规范进行评价,精准、全面、结构化地获取相关专家意见,以进一步改进服务规范的质量。方法 2019年12月,以AGREEⅡ工具为基础,结合本次评价目的,对工具进行一定的场景适应性修订,邀请社区和综合医院专家5名,使用修订后的AGREEⅡ工具对服务规范进行评价。结果 专家总体给出了较高的分数,单个条目得分均在4分以上(满分7分),平均得分均在5分以上,颈动脉服务规范的得分低于甲状腺服务规范,1名专家认为难以评分而放弃对颈动脉服务规范进行评分。结论 专家可能给出了较高的评价分数,根据评价结果,甲状腺服务规范质量较高并可推行应用,颈动脉服务规范得分相对较低,且专家对后续推进的可行性给出了较低的分数,暂不建议推行。从评价过程和评价结果来看,AGREEⅡ工具适合用作评价范围的指导,但对于内容本身的评价,建议使用效度理论对文本每段内容逐条进行评价,以深度收集专家意见,提升文本质量。

关键词: 社区卫生服务, 全科医生, 超声探查, 甲状腺, 颈动脉, 服务规范, 评价, AGREEⅡ

Abstract: Background To enable community general practitioners(GPs) to screen for thyroid and carotid diseases using the portable ultrasound device high efficiently and effectively at the community level,we developed the Specifications for Community General Practitioners to Screen for Thyroid and Carotid Diseases Using the Portable Ultrasound Device(hereinafter referred to as the Specifications). Objective To evaluate the quality of the Specifications using AGREEⅡ precisely,comprehensively and structurally by experts,to make further improvement. Methods In December 2019,for further improving the specifications via situation adaptation,we invited five experts from community and general hospitals to evaluate the specifications using the modified AGREEⅡ. Results On the whole,the items of the Specifications were rated high,each was rated higher than four out of seven points,with an average score of higher than five. Compared to the part of thyroid screening,the part of carotid screening was rated lower. And one expert abstained from the assessment for the part of carotid screening. Conclusion Overall,the experts rated the Specifications high,but specifically,they recommended the use of the part of thyroid screening owing to higher quality,but did not recommend the use of part of carotid screening presently due to lower quality and feasibility. Our study indicates that the AGREEⅡis suitable to be used to evaluate practice guidelines. In terms of evaluating the specific contents of such guidelines to improve the quality,we suggest to use the validity theory to perform a thorough item-by-item expert evaluation.

Key words: Community health services, General practitioners, Ultrasonography, Thyroid, Carotid artery, Service specification, Evaluation, AGREEⅡ