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中国全科医学

所属专题： 乳腺癌最新文章合集

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基层医疗卫生机构开展乳腺癌筛查能力评价指标体系构建研究

刘雪薇，陆鑫林，钟心媛，阮占良，王彦博，王媛，芦文丽*   

  1. 300070天津市，天津医科大学公共卫生学院流行病与卫生统计学系
  • 通讯作者: 芦文丽，教授，博士生导师；E-mail：luwenli@tmu.edu.cn
  • 基金资助:
    国家自然科学基金资助项目（72074166）

Development of a Breast Cancer Screening Capacity Assessment System for Primary Care Institutions

LIU Xuewei，LU Xinlin，ZHONG Xinyuan，RUAN Zhanliang，WANG Yanbo，WANG Yuan，LU Wenli*   

  1. Department of Epidemiology and Health Statistics，School of Public Health，Tianjin Medical University，Tianjin 300070，China
  • Contact: LU Wenli，Professor/Doctoral supervisor；E-mail：luwenli@tmu.edu.cn

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摘要： 背景　基层医疗卫生机构在开展乳腺癌筛查过程中受到许多因素制约，难以保证筛查工作取得实质性进展，因此建立一套科学、有效的基层医疗卫生机构开展乳腺癌筛查能力评价指标体系尤为重要。目的　构建基层医疗卫生机构开展乳腺癌筛查能力评价指标体系。方法　于 2022 年 9—10 月，通过文献检索和小组讨论初步拟定基层医疗卫生机构开展乳腺癌筛查能力评价指标体系库并设计专家函询表，于 2022 年 11—12 月采用目的抽样法邀请21名专家作为函询对象，根据函询结果计算专家积极系数、专家权威系数和专家协调系数，经过小组讨论最终确定指标体系，应用层次分析法确定各级指标权重系数并检验各级指标逻辑一致性。结果　专家咨询表全部收回且有效，专家积极系数为 100.0%，专家权威系数为 0.812，重要性专家协调系数为 0.209（P<0.001），最终确立的指标体系由结构、过程、结果 3 个一级指标，10 个二级指标和 56 个三级指标构成，3 个一级指标的权重分别为 0.310 8、0.195 8 和 0.493 4，各层级指标的一致性比率均 <0.100。结论　初步构建的基层医疗卫生机构开展乳腺癌筛查能力评价指标体系具有较高的权威性和科学性，有望为乳腺癌筛查能力评估相关研究提供指导与参考，指标体系的适用性和应用效果仍有待进一步验证。

关键词: 基层医疗卫生机构, 乳腺肿瘤, 癌症早期检测, 指标体系, 德尔菲法

Abstract: Background　Due to many barriers，it is difficult for primary medical institutions to ensure substantial achievements in breast cancer screening. So it is particularly important to establish a system for scientifically and effectively assessing the capacities of primary care institutions in conducting breast cancer screening. Objective　To construct a system for assessing the capacities of primary care institutions for conducting breast cancer screening. Methods　From September to October 2022，through literature review and group discussion，we developed an item pool of the initial version of Breast Cancer Screening Capacity Assessment System for Primary Care Institutions（BCSCASPCI）. Then we conducted an online Delphi survey between November and December 2022 using a self-developed questionnaire with a purposive sample of 21 experts for understanding their views regarding the initial version of BCSCASPCI，and the response coefficient，authority coefficient，and the Kendall's W of the survey were calculated. Finally，based on the results of the survey and a group discussion，the final version of the BCSCASPCI was determined. The Analytic Hierarchy Process was used to determine the weight coefficients of its indicators and to examine the logical consistency of indicators. Results　All the experts returned effective questionnaires，achieving a response rate of 100.0%，and the authority coefficient was 0.812，and the Kendall's W was 0.209（P<0.001）. The final version of the BCSCASPCI consists of 3 primary indicators（structure，process，and outcome），10 secondary indicators，and 56 tertiary indicators. The weight coefficients of the 3 primary indicators were 0.310 8，0.195 8 and 0.493 4，respectively. The consistency ratios of indicators at each level were <0.100. Conclusion　Our BCSCASPCI has proven to be highly authoritative and scientific， and is expected to provide guidance and reference for studies related to breast cancer screening capacity assessment. But the applicability and application effects of the system still needs further verification.

Key words: Primary medical institutions, Breast neoplasms, Early detection of cancer, Index system, Delphi method

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