Prescribers prefer people: The sources of information used by doctors for prescribing suggest that the medium is more important than the message

AIMS: The sources of prescribing information are legion but there is little knowledge about which are actually used in practice by doctors when prescribing. The aims of this study were to determine the sources of prescribing information considered important by doctors, establish which were used in practice, and investigate if hospital and primary care physicians differed in their use of the sources. METHODS: Two hundred general practitioners (GPs) and 230 hospital doctors were asked to rate information sources in terms of their importance for prescribing 'old' and 'new' drugs, and then to name the source from which information about the last new drug prescribed was actually derived. RESULTS: Among 108 GPs, the Drugs and Therapeutics Bulletin and medical journal articles were most frequently rated as important for information on both old and new drugs while pharmaceutical representatives and hospital/consultant recommendations were more important for information on new drugs, as opposed to old. In practice, information on the last new drug prescribed was derived from pharmaceutical representatives in 42% of cases and hospital/consultant recommendations in 36%, with other sources used infrequently. Among 118 hospital doctors, the British National Formulary (BNF) and senior colleagues were of greatest theoretical importance. In practice, information on the last new drug prescribed was derived from a broad range of sources: colleagues, 29%; pharmaceutical representatives, 18%; hospital clinical meetings, 15%; journal articles, 13%; lectures, 10%. GPs and hospital doctors differed significantly in their use of pharmaceutical representatives (42% vs 18%) and colleagues (7% vs 29%) as sources of prescribing information (P < 0.0001 for both). CONCLUSIONS: The sources most frequently rated important in theory were not those most used in practice, especially among GPs. Both groups under-estimated the importance of pharmaceutical representatives. Most importantly, the sources of greatest practical importance were those involving the transfer of information through the medium of personal contact.     

探讨单病种病例的选择标准

目的探讨单病种病例的选择标准。方法以本院的单病种管理为例,分析不同选择标准情况下的单病种数据。结果单病种病例选择对单病种管理（特别是公示单病种）影响很大。结论在权威部门进一步制定标准前,各卫生医疗机构进行单病种管理时应根据不同病种灵活运用。     

综合介入治疗原发性肝癌长期存活34例

目的探讨综合介入治疗原发性肝癌对提高患者生存率的临床价值。方法回顾性分析34例经综合介入治疗后存活5年以上的原发性肝癌患者的临床治疗和随访资料。结果介入治疗前肿瘤Ⅰ期20例,Ⅱ期14例;单发病灶23例,多发灶10例,巨块型1例;肿瘤直径<3 cm、3~5 cm、5~10 cm和>10 cm者分别为8例、18例、7例和1例。所有患者均采用TXCE联合其他治疗,均存活5年以上,其中1例存活11年。结论综合介入治疗可显著提高原发性肝癌患者生存率。