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年轻医生水平更高？

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mansh_zhu

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这个帖子发布于9年零242天前，其中的信息可能已发生改变或有所发展。

May 23, 2011 (Rome, Italy) — Younger doctors appear to be diagnosing and treating cardiovascular disease better than their older colleagues, according to the results of an Italian study [1].
根据一份意大利的研究结果，年轻医生在诊断与治疗心血管疾病上的表现似乎比年龄较大的同事更为出色。

The study, published in the June 2011 issue of the International Journal of Clinical Practice, was conducted by a team led by Dr Giuliano Tocci (Sant'Andrea Hospital, Rome, Italy).
这份研究发表在2011年6月国际临床实践期刊上，由意大利罗马的Sant'Andrea 医院Giuliano Tocci教授领导团队负责完成。

Tocci commented to heartwire : "We found that younger doctors followed best practice more than older doctors. Younger doctors were more likely to order diagnostic tests for global cardiovascular risk stratification as advised by guidelines and prescribed more guideline-recommended drugs, such as antiplatelet and glucose- and lipid-lowering agents, whereas older doctors were more likely to recommend lifestyle changes. And patients treated by older doctors had a lower rate of control of major cardiovascular risk factors, such as hypertension, dyslipidemia, and diabetes."
Tocci评论说：“我们发现年轻医生比高年资医生更会遵循最优处理方式。年轻医生倾向于依据指南推荐的总体心血管危险分层开出诊断检查，也倾向于处方指南推荐的药物，如抗血细胞及降糖降脂药物，而高年资医生却倾向于改变患者生活方式。高年资医生处理的病人在重大心血管风险，如高血压、血脂异常及糖尿病方面的病情控制都相对较低。”

He said these results reflected the better education of younger doctors. "In the past two decades there have been a growing number of specialist physicians, who have better education that reflects the most modern guidelines."
结果反映了年轻医生有着更好的受教育背景。“在过去的二十年，反映最新指南治疗方式的具有更优学术背景的专科医师人数不断增加。”

Too Many Guidelines
While Tocci says the availability of treatment guidelines are very useful, he thinks there are too many different sets of guidelines, which can be confusing for doctors. "We have several different guidelines for renal disease, blood pressure, cholesterol, diabetes, etc. Older doctors find it difficult to keep up with them all. We need fewer, simpler, more integrated guidelines."
Tocci提到治疗指南非常有用，但他同时指出指南种类太多，容易引起认知上的混乱。“肾脏病、血压、胆固醇、糖尿病等疾病都有好几种不同的治疗指南，高年资医生发现他们很难跟得上指南的更新速度。我们需要的是更简洁更综合的指南。”

The study also found that use of electronic support by doctors improved global cardiovascular risk management. Tocci gave the example of recording a high blood pressure result electronically, leading to a prompt that treatment was necessary. And unsurprisingly, young doctors were more likely to use electronic devices to improve practice than older doctors. Tocci suggested that additional educational support should be directed toward older doctors, especially in the use of electronic practice aids.
研究同时发现使用电子产品能提高总体心血管风险干预水平。Tocci教授以电子测量高血压为例，说明电子测量仪的使用有助及时进行必需的治疗。不出意外，年轻医生更倾向于使用电子产品提高疾病干预能力。Tocci教授提倡高年资医生需要更多的培训，特别是电子辅助仪器的使用。

The study found that younger doctors in the survey were more likely to be specialists, whereas older doctors were more likely to be general practitioners. While this accounted for some of the trend seen toward better practice in younger doctors, Tocci said the results remained the same after controlling for this variable.
研究发现年轻医生更可能成为专科医师，而高年资医生则更可能成为全科医生。Tocci教授说，这种现象也许解释了年轻医生通常拥有较高的疾病干预能力的趋势，在控制了这一变量以后，结果仍然相同。

The study did, however, find that aging in physicians was associated with improved accuracy in recording patients’ clinical data, with older physicians tending to provide significantly more clinical data.
然而，此研究发现随着医生年龄增长，记录患者临床资料的准确率上升，年龄越大的医生提供的临床资料越多。

Tocci said the most unsatisfactory result in the study was the level of control of hypertension, which was poor, irrespective of the age of referring physicians.
Tocci教授说，这个研究最不让人满意的结果是高血压的控制水平，高血压控制不良，而且与医生年龄不相关。

"Although 75% of the patient population was hypertensive, only 40% had their blood pressure controlled adequately. Everyone needs better education. This confirms the undertreatment of hypertension as a key element for the global burden of CV diseases in Western countries, including Italy," he said.
“尽管75%的病人患有高血压，只有其中的40%较好的控制血压水平。所有医生都需要接受更多的培训。这个结果确证了高血压的治疗不足是包括意大利在内的西方国家心血管疾病总体负担的主要因素。”

In the study, 1078 general practitioners, cardiologists, and diabetologists in Italy were asked to provide data on their 10 most recent patients' cardiovascular or metabolic disease, including figures on blood-pressure control, cholesterol, body-mass index, age, weight, diagnostic tests ordered, and medications prescribed. Data on a total of 9904 patients were analyzed. Physicians involved were stratified into three age groups--below 45 years, 46 to 55 years, and over 55 years.
在此项研究，意大利的1078名全科医生、心脏专科医生及糖尿病专科医生应要求提供了他们最近经治的10名患者心血管或代谢性疾病相关资料，包括血压控制的数字、胆固醇、BMI、年龄、体重、诊断检查及处方药物。研究人员对一共9904名病人的资料进行了分析，有关的医生被分成3个年龄组别：小于45岁、46到55岁及大于55岁。