THE AUTOMATED INTERVIEW VERSUS THE PERSONAL INTERVIEW - DO PATIENT RESPONSES TO PREOPERATIVE HEALTH QUESTIONS DIFFER

被引:52
作者
LUTNER, RE
ROIZEN, MF
STOCKING, CB
THISTED, RA
KIM, S
DUKE, PC
POMPEI, P
CASSEL, CK
机构
[1] UNIV CHICAGO, DEPT ANESTHESIA & CRIT CARE, CHICAGO, IL 60637 USA
[2] UNIV CHICAGO, DEPT MED, CHICAGO, IL 60637 USA
[3] UNIV CHICAGO, DEPT STAT, CHICAGO, IL 60637 USA
[4] UNIV MANITOBA, HLTH SCI CTR, WINNIPEG R3T 2N2, MANITOBA, CANADA
关键词
ANESTHESIA; PREOPERATIVE EVALUATION; EQUIPMENT; COMPUTERS; RECORDS; MEDICAL; AUTOMATION; TESTING; PREOPERATIVE;
D O I
10.1097/00000542-199109000-00003
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Laboratory testing of presurgical patients has been shown to be excessive, thereby increasing costs, reducing resources for other health care uses, and increasing risks to both patients and physicians. As one step toward reducing the number of unnecessary preoperative tests ordered, we used an automated method to aid preoperative assessment of 239 patients in Chicago and in Winnipeg. The "HealthQuiz," a small hand-held device containing a computer chip and video screen, uses a decision tree to ask a minimum of 60 health-related questions (the patient's response to certain questions determines the number of questions presented). The device then generates a summary printout of patient answers, the health areas needing further attention, and the laboratory tests most likely to uncover clinically important abnormalities in that patient. HealthQuiz responses are intended to aid the physician and not to replace the personal interview. As an aid, the automated interview highlights possible problem areas for in-depth pursuit by the physician. The need for nonselective batteries of tests is eliminated because recommendations for tests are based on specific elements of a patient's history. To be effective, responses to the HealthQuiz should be the same as responses to similar questions asked by a physician. We tested that premise in this study. Patient's answers to the HealthQuiz were compared with their responses to a randomly selected set of the same questions in a personal interview. Ninety-seven percent of the response pairs were identical, and most of the 3% that differed involved changes from "not sure" replies to the HealthQuiz. Laboratory tests suggested by responses to the two methods of questioning did not differ. We conclude that an automated system for obtaining health histories and selecting laboratory tests could be used by most patients who read English, and that patients from differing socioeconomic backgrounds would respond similarly to both video and oral presentation of questions.
引用
收藏
页码:394 / 400
页数:7
相关论文
共 37 条
[1]   COST CONTAINMENT AND THE PHYSICIAN [J].
ANGELL, M .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1985, 254 (09) :1203-1207
[2]  
APFELBAUM J, 1989, Anesthesiology (Hagerstown), V71, pA928, DOI 10.1097/00000542-198909001-00928
[3]  
BLERY C, 1986, LANCET, V1, P139
[4]   PROSPECTIVE ASSESSMENT OF A PROTOCOL FOR SELECTIVE ORDERING OF PREOPERATIVE CHEST X-RAYS [J].
CHARPAK, Y ;
BLERY, C ;
CHASTANG, C ;
SZATAN, M ;
FOURGEAUX, B .
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 1988, 35 (03) :259-264
[5]  
CHODOFF P, 1969, ANESTH ANAL CURR RES, V48, P870
[6]  
DAUGHADAY WH, 1969, EVALUATION ROUTINE 1, P181
[7]  
DELAHUNT B, 1980, NEW ZEAL MED J, V92, P431
[8]   THE ABNORMAL SCREENING SERUM THYROXINE (T4) - ANALYSIS OF PHYSICIAN RESPONSE, OUTCOME, COST AND HEALTH EFFECTIVENESS [J].
EPSTEIN, KA ;
SCHNEIDERMAN, LJ ;
BUSH, JW ;
ZETTNER, A .
JOURNAL OF CHRONIC DISEASES, 1981, 34 (05) :175-190
[9]   PREVENTIVE CARE GUIDELINES - 1991 [J].
HAYWARD, RSA ;
STEINBERG, EP ;
FORD, DE ;
ROIZEN, MF ;
ROACH, KW .
ANNALS OF INTERNAL MEDICINE, 1991, 114 (09) :758-+
[10]   QUALITY OF MEDICAL CARE - TECHNIQUES AND INVESTIGATION IN OUTPATIENT CLINIC [J].
HUNTLEY, RR ;
WILLIAMS, TF ;
STEINHAUSER, R ;
PASTERNACK, BS ;
WHITE, KL ;
MARTIN, DA .
JOURNAL OF CHRONIC DISEASES, 1961, 14 (06) :630-+