Laboratory screening at preventive health exams - Trend of testing, 1978-2004

被引:15
作者
Chacko, Karen M. [1 ]
Feinberg, Lawrence E. [1 ]
机构
[1] Univ Colorado, Hlth Sci Ctr, Div Gen Internal Med, Denver, CO 80202 USA
关键词
D O I
10.1016/j.amepre.2006.09.002
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Routine laboratory screening at preventive health exams continues to be a common practice despite expert opinion dating back to 1979 that supports only a few screening tests for apparently healthy adults. This report describes trends in such testing over a 27-year period. Methods: Primary care physicians were surveyed five times between 1978 and 2004 at a yearly educational meeting in Colorado. Based on case vignettes describing two apparently healthy adults, physicians indicated which laboratory tests they would routinely order. Results: Of a total of 2364 surveys collected during years 1978, 1983, 1988, 1999, and 2004, the corresponding percentage of physicians respondents who state they would order the following tests for a healthy man aged 35 years were: complete blood count (CBC) (87, 75, 73, 49, 46); urinalysis (UA) (93, 86, 79, 52, 44); chemistry panel (CHEM) (57, 48, 36, 43, 55); and electrocardiogram (ECG) (37, 27, 24, 9, 6). For a healthy woman aged 55 years, the corresponding percentages for each test were: CBC (89, 89, 86, 64, 67); UA (96, 93, 88, 62, 55); CHEM (70, 70, 66, 57, 76); ECG (63, 51, 51, 33, 29); and thyroid stimulating hormone (14, 20, 28, 42, 57). Conclusions: Although currently practicing physicians continue to report that they order screening tests for apparently healthy people, this practice appears to have decreased over the past 27 years. This trend may reflect expert guidelines and emphasis on medical cost containment.
引用
收藏
页码:59 / 62
页数:4
相关论文
共 20 条
[11]   Quality of US outpatient care - Temporal changes and racial/ethnic disparities [J].
Ma, J ;
Stafford, RS .
ARCHIVES OF INTERNAL MEDICINE, 2005, 165 (12) :1354-1361
[12]   Public expectations and attitudes for annual physical examinations and testing [J].
Oboler, SK ;
Prochazka, AV ;
Gonzales, R ;
Xu, S ;
Anderson, RJ .
ANNALS OF INTERNAL MEDICINE, 2002, 136 (09) :652-659
[13]   Comparison of vignettes, standardized patients, and chart abstraction - A prospective validation study of 3 methods for measuring quality [J].
Peabody, JW ;
Luck, J ;
Glassman, P ;
Dresselhaus, TR ;
Lee, M .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2000, 283 (13) :1715-1722
[14]   Support of evidence-based guidelines for the annual physical examination - A survey of primary care providers [J].
Prochazka, AV ;
Lundahl, K ;
Pearson, W ;
Oboler, SK ;
Anderson, RJ .
ARCHIVES OF INTERNAL MEDICINE, 2005, 165 (12) :1347-1352
[15]  
Romm F J, 1987, Fam Pract Res J, V7, P69
[16]  
STANGE KC, 1992, J FAM PRACTICE, V34, P409
[17]  
U.S. Preventive Services Task Force, 2020, Guide to Clinical Preventive Services
[18]   Prostate cancer screening practices and beliefs - A longitudinal physician survey [J].
Voss, JD ;
Schectman, JM .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2001, 16 (12) :831-837
[19]   SCREENING PROCEDURES IN THE ASYMPTOMATIC ADULT - COMPARISON OF PHYSICIANS RECOMMENDATIONS, PATIENTS DESIRES, PUBLISHED GUIDELINES, AND ACTUAL PRACTICE [J].
WOO, B ;
WOO, B ;
COOK, EF ;
WEISBERG, M ;
GOLDMAN, L .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1985, 254 (11) :1480-1484
[20]   INITIAL CLINICAL JUDGMENTS BY INTERNISTS, FAMILY PHYSICIANS, AND PSYCHIATRISTS IN RESPONSE TO PATIENT VIGNETTES .2. ORDERING OF LABORATORY TESTS, CONSULTATIONS, AND TREATMENTS [J].
YAGER, J ;
LINN, LS ;
LEAKE, B ;
GASTALDO, G ;
PALKOWSKI, C .
GENERAL HOSPITAL PSYCHIATRY, 1986, 8 (03) :152-158