摘要
目的:分析三甲医院心内科医师对定量血流分数测量系统的认知与评价,为我国定量血流分数测量系统的发展和临床应用提供决策依据.方法:对上海市、湖北省和甘肃省 9 所三甲医院心内科医师进行问卷调查,采用χ2检验、t检验和logistic回归等方法分析医师对定量血流分数测量系统优势和风险的认知以及对该系统有效性、安全性、经济性和推广应用等方面的评价.结果:心内科医师认为定量血流分数测量系统位列前3 位的优势是"可提高诊断效率"(72.89%)、"诊断准确率高"(54.22%)和"可降低诊断费用"(52.41%),认为该系统前3 位的风险是"缺乏统一诊断标准"(68.07%)、"误诊风险增加"(46.99%)和"医疗诊断费用增加"(46.39%).135 位(81.33%)心内科医师支持或较支持此系统在临床上的应用,有操作经历的医师对此系统的支持度更高(OR=6.36).心内科医师对该系统诊断冠脉狭窄的安全性、有效性、经济性和应用推广的认可度总体较高(评分均值为3.70-3.88 分).结论:三甲医院心内科医师对定量血流分数测量系统在临床实践中的优势和推广价值积极认可.我国可加强该系统操作质量和内部管理,进一步验证其在不同患者群体和临床环境中的应用效果,以利于优化诊断治疗决策,改善预后和合理配置医疗资源.
Abstract
Objective:To analyze the perception and assessment of cardiologists in grade-A tertiary hospitals towards quanti-tative flow ratio(QFR)measurement system,so as to provide decision-making basis for the development and clinical application of the QFR measurement system in China.Methods:A questionnaire survey was conducted among cardiologists in 9 grade-A tertiary hospitals in Shanghai,Hubei and Gansu.Chi-square test,t test,and logistic regression were employed to analyze cardiologists'perception of the benefits and risks of QFR measurement system,as well as assessment of its effectiveness,safety,economy,and promotion.Results:Cardiologists identified the top three benefits of QFR as"improved diagnostic efficiency"(72.89%),"high diagnostic accuracy"(54.22%),and"reduced diagnostic expense"(52.41%).The top three risks of the system were"lack of u-nified diagnostic standard"(68.07%),"increased risk of misdiagnosis"(46.99%),and"increased diagnostic expense"(46.39%).135 cardiologists(81.33%)supported or somewhat supported the clinical application of QFR,with cardiologists who had operational experience showing higher support rate(OR=6.36).Overall,cardiologists expressed a relatively high level of approval for the safety,effectiveness,economy,and applicability promotion of the QFR in diagnosing coronary artery stenosis with average scores ranging from 3.70 to 3.88.Conclusion:Cardiologists actively recognize the benefits and promotion value of the QFR meas-urement system in clinical practice in grade-A tertiary hospitals.China can enhance the operational quality and internal manage-ment of the QFR measurement system,further verify its application in different patient populations and clinical environments,opti-mize diagnostic and treatment decisions,improve prognosis,and rationally allocate medical resources.
维普
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