2015年5月5日 星期二

[研究發表摘錄介紹] 藉由紅斑性狼瘡問卷(Systemic Lupus Erythematosus Questionnaire , SLEQ)為基礎教育患者與訓練住院醫師,可達到與資深主治醫師有8成5以上的一致性

[研究發表摘錄介紹] 

藉由紅斑性狼瘡問卷(Systemic Lupus Erythematosus Questionnaire , SLEQ)為基礎教育患者與訓練住院醫師,可達到與資深主治醫師有8成5以上的一致性




        本篇一致性論文主要是在討論紅斑性狼瘡(Systemic Lupus Erythematosus, SLE)患者就診時,利用紅斑性狼瘡問卷(Systemic Lupus Erythematosus Questionnaire , SLEQ)調查SLE患者、住院醫師及資深主治醫師對 152 項問診症狀,住院醫師及資深主治醫師對20 項舌診型態及 15 項脈診型態,判定 3 位觀察者之間有無一致性。
        研究結果顯示,不論是患者或住院醫師對中醫症狀或舌脈診,經過教育與訓練後與資深主治醫師的準確度會趨於一致這在中醫藥研究上屬於少見,尤其是一次討論 3 個觀測者對 187 個項目之一致性更是首見若能藉由問卷為基礎教育患者與訓練住院醫師,並達到與資深主治醫師有8成5以上的一致性,那未來患者利用問卷填答可加速問診之準確性

    The disease-specific diagnosis questionnaires should be able to guide the junior doctors in learning the features of the most common diseases. We may encourage them to collaborate with the objective structured clinical examination (OSCE)2122232425 and 26 in the training course for TCM resident doctors.
    The purpose of the SLEQ was designed for education and training. The patient (P), resident doctor (R) and senior supervisor (S) filled all the questions in sequence independently. In order to find the potential mistakes and correct them, the later rater assumed that the previous rater made mistakes and they need to examine the questionnaire with a critical eye, so that the evaluation of agreement would not be influenced by any potential bias.
    Through this training process based on questionnaire-reported diagnosis, we could improve the inter-rater reliability of TCM diagnosis.27 and 28 The P's responses and R's responses to the SLEQ could almost be the same as S, provided that the agreements among P, R and S were good enough. Higher agreement could set objective and standard assessments.29 and 30 This would serve the purpose of raising the quality of medical practice. In future, we may develop the tele-care service for TCM further.

Complementary Therapies in Medicine摘錄Discussion部份內容:
Ching-Mao Chang, Wen-Hsiang Wu, Benjamin Ing-Tiau Kuo, Tzung-Yan Lee, Chia-Yu Liu, Hen-Hong Chang*: Using A Questionnaire among Patient, Resident Doctor and Senior Supervisor: Are their Answers the Same? Complementary Therapies in Medicine. 2014 (SCI, 2012 IF=2.216)