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Clinical outcome indicators, disease prevalence and test request variability in primary care.

机译:初级保健的临床结果指标、疾病患病率和检测请求变异性。

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AIM: To describe differences in biochemistry test request rates (adjusted for practice size) between general practices and to investigate whether differences in HbA(1c) and thyroid function test request rates are related either to the practice prevalence of hypothyroidism and diabetes or to Quality and Outcome Framework (QOF) scores. METHODS: Information on test request rates, prevalence of diabetes and hypothyroidism, and QOF data over a one-year period were obtained from 58 practices covering a population of 284,609 patients. Spearman's rank correlation tests were used to investigate relationships between adjusted test request rates. RESULTS: There was wide variability in adjusted test request rates (lowest for HbA(1c) and highest for immunoglobulins). The ranking of practices for different tests was highly correlated. There was no relationship between adjusted test request rates for HbA(1c) and thyroid function and the reported prevalence of diabetes and hypothyroidism, respectively, nor was there any relationship with QOF scores in diabetes and hypothyroidism. CONCLUSIONS: There is wide variability in test request rates in general practice that do not appear to be related to disease prevalence or crude clinical outcome measures.
机译:目的:描述全科诊所之间生物化学测试请求率(根据实践规模调整)的差异,并调查 HbA(1c) 和甲状腺功能测试请求率的差异是否与甲状腺功能减退症和糖尿病的实践患病率或质量和结果框架 (QOF) 分数有关。方法: 从覆盖 284,609 名患者的 58 个诊所获得有关测试请求率、糖尿病和甲状腺功能减退症患病率以及一年内 QOF 数据的信息。Spearman 的秩相关检验用于研究调整后的测试请求率之间的关系。结果:调整后的检测请求率存在很大差异(HbA(1c)最低,免疫球蛋白最高)。不同测试的实践排名高度相关。调整后的 HbA(1c) 和甲状腺功能检测请求率分别与报告的糖尿病和甲状腺功能减退症患病率之间没有关系,也与糖尿病和甲状腺功能减退症的 QOF 评分没有任何关系。结论:在一般实践中,测试请求率存在很大差异,似乎与疾病患病率或粗略的临床结果测量无关。

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