Abstract: Background　Hypothyroidism has become a common disease in communities. Although multiple versions of adult hypothyroidism guidelines and grassroots guidelines have been released in China, there is relatively little research on the knowledge and clinical skills of community general practitioners. Objective　To investigate and analyze the mastery of knowledge and clinical skills related to hypothyroidism among community general practitioners, to provide a reference for promoting the standardized treatment management of community hypothyroidism patients. Methods　From January 15th to January 30th, 2024, based on the regional division of urban and rural areas in Pudong New District, Shanghai, 341 general practitioners from 9 community health service centers were randomly selected for an online survey. The survey questionnaire was developed in combination with relevant guidelines and expert consensus on hypothyroidism, including basic information of general practitioners, knowledge related to hypothyroidism, and clinical skill test questions (covering three dimensions: etiology and screening, identification and diagnosis, treatment management and referral) . It uses multiple linear regression analysis to examine the influencing factors of general practitioners' mastery of hypothyroidism-related knowledge in the community. Result　A total of 341 questionnaires were distributed and 338 (99.12%) valid questionnaires were collected. The average correct rate of general practitioners on the etiology and screening, identification and diagnosis, treatment management and referral knowledge of hypothyroidism was 68.37% (2 542/3 718) , 61.06% (2 683/4 394) , 77.78% (4 206/5 408) , with an average score of (69.74±13.98) . The proportion of general practitioners who can independently diagnose and treat elderly hypothyroidism patients with guidelines is only 9.47% (32/338) . The results of the multiple linear regression analysis showed that the factors such as professional title, gender, educational background, age, and the way of treating elderly patients with hypothyroidism were the influencing factors for the etiology and screening dimension, identification and diagnosis dimension, treatment management and referral dimension, and total score of the test questions on thyroid-related knowledge and clinical skills of general practitioners (P<0.05) .Professional title and the way of diagnosing and treating elderly patients with hypothyroidism are positive predictors of the scores in the dimensions of etiology and screening (P<0.05) .Gender and educational attainment are positive predictors of the scores in the identification and diagnosis dimensions (P<0.05) . Age is a negative predictor for the dimensions and total score of recognition and diagnosis (P<0.05) .Educational background and the approach to treating elderly patients with hypothyroidism are positive predictors of the scores in the dimensions of diagnosis management and referral (P<0.05) .Educational background and the approach to treating elderly patients with hypothyroidism are positive predictors of the score (P<0.05) . Conclusion　The knowledge and clinical skills of general practitioners in Shanghai Pudong New Area regarding hypothyroidism need to be improved. Particularly, their abilities in screening, identification and diagnosis of hypothyroidism are insufficient, and their practical experience in the diagnosis and management of elderly patients with hypothyroidism is also inadequate. It is necessary to strengthen the training of general practitioners with lower education levels, who are over 30 years old and who lack community practice and management of elderly patients with hypothyroidism.

Key words: Hypothyroidism, General Practitioner, Knowledge, Investigation and Analysis

摘要： 背景　甲状腺功能减退症（以下简称甲减）已成为社区常见病，虽然国内发布了多版成人甲减指南及基层指南，但对社区全科医生甲减相关知识及临床技能掌握情况的研究有限。目的　调查分析社区全科医生对甲减相关知识及临床技能的掌握情况，为推进甲减患者基层规范化诊疗管理提供依据。方法　2024-01-15—01-30依照上海市浦东新区城乡的地域划分，分层随机整群抽取9家社区卫生服务中心的341位全科医生在线调查，问卷结合甲减相关指南及专家共识自行研制，内容包括全科医生基本信息、甲减相关知识及临床技能测试题（包括病因与筛查、识别与诊断、诊疗管理与转诊3个维度），采用多元线性回归分析社区全科医生甲减相关知识掌握情况的影响因素。结果　共发放问卷341份，共回收有效问卷338份（99.12%）。全科医生对甲减的病因与筛查、识别与诊断、诊疗管理与转诊知识的平均正确率依次为68.37%（2 542/3 718）、61.06%（2 683/4 394）、77.78%（4 206/5 408），平均分为（69.74±13.98）分。能结合指南独自诊疗老年甲减患者仅为9.47%（32/338）。多元线性回归分析结果显示，职称、性别、学历、年龄、诊疗老年甲减患者的方式是全科医生甲减相关知识及临床技能测试题中病因与筛查维度、识别与诊断维度、诊疗管理与转诊维度及总分的影响因素（P<0.05）。职称与诊疗老年甲减患者方式是病因与筛查维度得分的正向预测因子（P<0.05），性别、学历是识别与诊断维度得分的正向预测因子（P<0.05），年龄是识别与诊断维度及总分的负向预测因子（P<0.05），学历与诊疗老年甲减患者方式是诊疗管理与转诊维度得分的正向预测因子（P<0.05），学历与诊疗老年甲减患者方式是总分的正向预测因子（P<0.05）。结论　上海市浦东新区全科医生对甲减相关知识及临床技能的掌握有待提高，尤其对甲减的筛查、识别与诊断能力欠佳，对老年甲减患者诊疗及管理实践不足。需加强较低学历、≥30岁、缺乏社区诊疗与管理老年甲减患者实践的全科医生的培训。

关键词: 甲状腺功能减退症, 社区全科医生, 知识, 调查分析