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背景和目的肥胖乃为最常见的健康隐患,可极大地增加患包括心脏病乃至癌症在内诸多疾病的风险。尽管医生的咨询服务可提高尝试减肥和增强运动的患者比例,但初级保健医生常常都关注肥胖症。本研究的目的是测定肥胖症在病症表中出现的频率以及将肥胖症加入到病症表中是否会影响之后就诊中的医生对肥胖症的关注率。方法我们首先评估分析从美国一诊所家庭医学科住院医师办公室获取的患者记录资料,之后以记录为对象进行一随机对照试验。该试验干预或处理为:病症表中加入肥胖症。该试验的结果检测指标为:干预后的5个月内,肥胖症是否被列入诊断项目中。结果在基线水平,36.2%肥胖患者的病症列表包括肥胖症。在这些患者中,有55.5%的患者在过去的一年里得到过医生对其肥胖症的关注,而这一百分比在肥胖症未列入病症表中的患者只有5.1%。在干预后5个月中,干预组258位患者中的38位(14.7%)得到过医生对肥胖症的关注,而对照组239位患者中只有11位(4.6%)才得到过医生对肥胖症的关注。结论病症表中加入肥胖症与之后就诊时医生对肥胖症的关注有明显的正相关。这种简单的干预,完全可以利用电子病例(EMR)系统自动完成,且具有改变医生的职业行为的巨大潜力。
Background and Objective Obesity is the most common health risk that can greatly increase the risk of many diseases, including heart disease and even cancer. Although physician counseling can increase the proportion of patients trying to lose weight and increase physical activity, primary care physicians often focus on obesity. The purpose of this study was to determine if the incidence of obesity in the symptom table and whether obesity was added to the list of conditions would influence the rate of obesity among follow-up physicians. Methods We first evaluated and analyzed patient records obtained from the Residency of Family Medicine Clinic at a clinic in the United States before conducting a randomized controlled trial of the record. Interventions or treatments for this trial include: Obesity is added to the list of conditions. The test results of the test indicators: within 5 months after intervention, obesity is included in the diagnosis of the project. Results At baseline, the list of disorders in 36.2% of obese subjects included obesity. In these patients, 55.5% of the patients received the doctor’s attention for their obesity in the past year, while this percentage was only 5.1% in those patients whose obesity was not included in the symptom list. In the five months after intervention, 38 (14.7%) of the 258 patients in the intervention group were obliged to pay attention to obesity, compared with 11 (4.6%) of the 239 patients in the control group who received obesity Symptoms of concern. Conclusion Addition of obesity to the list of conditions has a clear positive correlation with the doctor’s concern for obesity. This simple intervention is entirely automated using an electronic case (EMR) system and has the potential to change a doctor’s professional behavior.