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[Decision-making about gout by physicians of China and influencing factors thereof].
Zhonghua Yi Xue Za Zhi 2006; 86(27):1901-5ZY

Abstract

OBJECTIVE

To investigate the decision-making about gout by physicians of China and influencing factors thereof.

METHODS

A questionnaire survey, including 13 multiple choice questions, was divided into 2 stages. The first/stage questionnaire survey was conducted among 121 physicians of the departments of internal medicine and rheumatology respectively during the grand ward rounds, and the second-stage questionnaire survey was conducted among 75 physicians attending a national continuous medical education (CME) workshop of rheumatology. The data thus collected were pooled and analyzed by logistic regression models.

RESULTS

62 effective questionnaires were collected in the first/stage survey, and 38 effective questionnaires were collected in the second-stage survey, both with a missing rate < 10%. 78.3% of the respondents considered aspiration of the joint fluid as critical for the definitive diagnosis of gout, but only 2.4% of the respondents did so frequently. When treating acute gout in otherwise healthy patients, 69.2% of the respondents preferred oral colchicine, and while treating the patients with renal dysfunction, 41.7% of the respondents used corticosteroids or corticotrophin as the first choice. For long-term uric acid-lowering therapy, 99 of them (82.5%) described a variety of incorrect indications, 107 of them (89.2%) initiated the treatment too early (< or = 2 weeks after the remission), and 92 of them (76.7%) failed to sustain the treatment for at least 5 years. Only 17 physicians (14.2%) used prophylaxis while initiating the uric acid-lowering treatment and only 7 of them (5.8%) selected a prophylaxis time of 7 approximately 12 months. Multiple logistic regression analysis showed that only CMD on gout was associated with correct diagnosis strategy (OR 7.1, 95% CI 2.1 approximately 23.7).

CONCLUSION

The management of gout by the physicians in China is often not consistent with that generally accepted internationally. High quality CME may improve the decision-making ability of physicians.

Authors+Show Affiliations

Department of General Internal Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Research Support, Non-U.S. Gov't

Language

chi

PubMed ID

17064528

Citation

Fang, Wei-gang, et al. "[Decision-making About Gout By Physicians of China and Influencing Factors Thereof]." Zhonghua Yi Xue Za Zhi, vol. 86, no. 27, 2006, pp. 1901-5.
Fang WG, Zeng XJ, Li MT, et al. [Decision-making about gout by physicians of China and influencing factors thereof]. Zhonghua Yi Xue Za Zhi. 2006;86(27):1901-5.
Fang, W. G., Zeng, X. J., Li, M. T., Chen, L. X., Schumacher, H. R., & Zhang, F. C. (2006). [Decision-making about gout by physicians of China and influencing factors thereof]. Zhonghua Yi Xue Za Zhi, 86(27), pp. 1901-5.
Fang WG, et al. [Decision-making About Gout By Physicians of China and Influencing Factors Thereof]. Zhonghua Yi Xue Za Zhi. 2006 Jul 18;86(27):1901-5. PubMed PMID: 17064528.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Decision-making about gout by physicians of China and influencing factors thereof]. AU - Fang,Wei-gang, AU - Zeng,Xue-jun, AU - Li,Meng-tao, AU - Chen,Lan X, AU - Schumacher,H Ralph,Jr AU - Zhang,Feng-chun, PY - 2006/10/27/pubmed PY - 2007/7/28/medline PY - 2006/10/27/entrez SP - 1901 EP - 5 JF - Zhonghua yi xue za zhi JO - Zhonghua Yi Xue Za Zhi VL - 86 IS - 27 N2 - OBJECTIVE: To investigate the decision-making about gout by physicians of China and influencing factors thereof. METHODS: A questionnaire survey, including 13 multiple choice questions, was divided into 2 stages. The first/stage questionnaire survey was conducted among 121 physicians of the departments of internal medicine and rheumatology respectively during the grand ward rounds, and the second-stage questionnaire survey was conducted among 75 physicians attending a national continuous medical education (CME) workshop of rheumatology. The data thus collected were pooled and analyzed by logistic regression models. RESULTS: 62 effective questionnaires were collected in the first/stage survey, and 38 effective questionnaires were collected in the second-stage survey, both with a missing rate < 10%. 78.3% of the respondents considered aspiration of the joint fluid as critical for the definitive diagnosis of gout, but only 2.4% of the respondents did so frequently. When treating acute gout in otherwise healthy patients, 69.2% of the respondents preferred oral colchicine, and while treating the patients with renal dysfunction, 41.7% of the respondents used corticosteroids or corticotrophin as the first choice. For long-term uric acid-lowering therapy, 99 of them (82.5%) described a variety of incorrect indications, 107 of them (89.2%) initiated the treatment too early (< or = 2 weeks after the remission), and 92 of them (76.7%) failed to sustain the treatment for at least 5 years. Only 17 physicians (14.2%) used prophylaxis while initiating the uric acid-lowering treatment and only 7 of them (5.8%) selected a prophylaxis time of 7 approximately 12 months. Multiple logistic regression analysis showed that only CMD on gout was associated with correct diagnosis strategy (OR 7.1, 95% CI 2.1 approximately 23.7). CONCLUSION: The management of gout by the physicians in China is often not consistent with that generally accepted internationally. High quality CME may improve the decision-making ability of physicians. SN - 0376-2491 UR - https://www.unboundmedicine.com/medline/citation/17064528/[Decision_making_about_gout_by_physicians_of_China_and_influencing_factors_thereof]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=0376-2491&amp;year=2006&amp;vol=86&amp;issue=27&amp;fpage=1901 DB - PRIME DP - Unbound Medicine ER -