tbuckley/cabot-search huggingface dataset:
Checkpoint inhibitors related renal vasculitis and use of rituximab.
Authors: Omar Mamlouk, Jamie Lin, Amanda Tchakarov, William F Glass, Maen Abdelrahim, Umut Selamet, Maryam Buni, Noha Abdelwahab, Ala Abudayyeh
Journal: Journal of Clinical Oncology (2020)

e15145 Background: As the percentage of cancer patients eligible for checkpoint inhibitor therapy (CPI) is increasing rapidly over the past couple years and approaching 45%, more cases of CPI related nephrotoxicity, including a rare subset with vasculitis, are reported. To learn more about the clinical presentation of CPI associated renal vasculitis, its mechanism, treatment options, and prognosis, we describe cases from our institution and reviewed the literature for related cases. Methods: We retrospectively reviewed the charts of all cancer patients from 2014 to 2020 who were diagnosed with CPI related nephrotoxicity and underwent a kidney biopsy. Results: We identified 6 cases of renal vasculitis reach with different malignancy, 4 had pauci-immune GN and one of which had IgA vasculitis. 4 of the patients were on nivolumab and 4 of the patients had negative ANCA serology. All patients had microscopic hematuria and severe acute kidney injury (AKI) with Creatinine &gt; 4.5 mg/dl upon diagnosis and 2 patients requiring renal replacement therapy (RRT). One patient had concurrent lung involvement. All patients were treated by discontinuing CPI and initiating corticosteroids and rituximab. 3 patients received plasmapheresis who required RRT or had lung involvement. 2 patients died within 8 months of diagnosis due to malignancy progression and none of the cases had a relapse of vasculitis. Conclusions: We demonstrated that CPI can be associated with different types of renal vasculitis that is predominantly ANCA negative and manifest as severe kidney. Despite the lack of strong evidence, treatment as primary ANCA vasculitis with corticosteroids and rituximab is well tolerated with favorable renal outcome.
Impact of frontline doublet versus triplet therapy on clinical outcomes: Exploratory analysis from the RAINBOW study.
Authors: Samuel J Klempner, Zev A. Wainberg, Kei Muro, Joseph Chao, Daniel V.T. Catenacci, Jaffer A. Ajani, Salah-Eddin Al-Batran, Nikki Toms, Holly Knoderer, Ran Wei, Astra M. Liepa, Anindya Chatterjee, Atsushi Ohtsu
Journal: Journal of Clinical Oncology (2020)

4543 Background: Treatment (tx) of advanced gastric cancer (GC/GEJ) is highly heterogeneous, with substantial variability in tx patterns. Frontline tx choice may affect outcomes of subsequent tx, thereby influencing choice/efficacy of second-line (2L) tx. In RAINBOW, 2L ramucirumab(R) plus paclitaxel(P) significantly improved overall survival (OS) of patients (pts) with GC/GEJ. Here we explore efficacy, safety and quality of life (QoL) based on prior tx. Methods: Pts were grouped into doublet (DB) or triplet (TP) regimens based on prior cytotoxic tx received. OS and PFS were estimated using Kaplan-Meier method and tx effects on OS and PFS were evaluated by Cox PH model; safety and QoL were assessed descriptively for DB vs TP. Results: Use of DB and TP was similar between arms, with 23% in R+P and 26% in placebo (PB)+P arm receiving TP. Baseline characteristics were generally balanced between tx arms within DB and TP subgroups, with majority of TP administered in western regions (91%). Pts ≥65 years of age was 40% for DB and 28% for TP. DB pts (n = 498; 75%) received S1+cis (n = 97, 15%) and cape+ox (n = 71; 11%) as most common prior tx, while TP pts (n = 163; 25%) received epi+cape+ox (n = 74, 11%) and epi+cis+5FU (n = 53, 8%). Similar to ITT population, R+P improved OS and PFS in both DB and TP subgroups (Table). Patterns of overall and Grade ≥3 TEAEs between arms were similar regardless of prior tx. Higher rates of serious TEAEs were reported in TP pts (57%, 49%) than DB pts (44%, 40%) in R+P and PBO+P arms, respectively. Similar trend was observed for TEAEs leading to discontinuation for TP (40%, 30%) vs DB (29%, 22%) in respective tx arms. Baseline QoL scores were similar between tx arms within subgroups, but mean scores were &gt; 5 points worse (range 0-100) for prior TP for role functioning, fatigue, pain, and appetite loss. Changes in mean scores were generally similar between arms and within subgroups. Conclusions: This exploratory analysis of RAINBOW suggests that although safety-related outcomes were less favorable in pts with prior TP, regardless of tx arm, similar improvements in efficacy were noted for R+P irrespective of prior DB or TP. Clinical trial information: NCT01170663 . [Table: see text]
Phyllodes tumor of breast, real-world data from a referral center in Mexico.
Authors: María Inés Contreras-Salcido, Carlos Eduardo Salazar-Mejía, Adriana González-Gutiérrez, Rolando Jacob Martinez, Jackeline Grace Lara-Campos, Jose Luis Gonzalez Vela, Edio Llerena, Oscar Vidal-Gutiérrez, David Hernández-Barajas, Juan Francisco González-Guerrero
Journal: Journal of Clinical Oncology (2020)

e19356 Background: Phyllodes tumors of breast (PTB) comprise a wide range of rare fibroepithelial neoplasms representing less than 1% of all breast tumors. Studies that describe the clinical characteristics of Mexican women with PTB are scarce. Methods: We performed a retrospective analysis of all patients with newly diagnosed PTB treated at an oncology referral center in Northeast Mexico from 2013 to 2018. Results: Twenty-three women were included in the analysis. Median age at diagnosis was 51 years. Diagnosis was made by self-detection in all cases, with a median tumor size of 12.8 cm. Approximately 26% of patients had a history of benign breast disease. Regarding treatment received 39% underwent radical mastectomy whereas simple mastectomy and breast-conserving surgery were performed in 39 and 22%, respectively. PTB were classified as benign, borderline, and malignant in 17, 13, and 70% of cases, respectively. Patients with malignant PTB showed a heterologous component in 22% of cases (60% with mixed histology, 20% fibromyxosarcoma, and 20% osteosarcoma). Metastatic disease at diagnosis was documented in 3 patients. Relapse of disease was confirmed in eight patients, two of them corresponded with borderline histology and six to malignant subtype. Recurrence sites by frequency were locoregional only 38%; distant disease to the lungs only 12%; and combined metastases to lung, liver and central nervous system 50%. Regarding management of recurrence, four patients received chemotherapy, two received only radiotherapy, one was treated with radiotherapy and chemotherapy and one woman received surgical treatment with adjuvant radiotherapy. Among all patients analyzed, the median overall survival was 23.6 months. Conclusions: To our knowledge, this is one of the first studies analyzing the clinical-pathological characteristics of phyllodes tumors in the Mexican population.
Comparison of two criteria for evaluating severity of community-acquired pneumonia in China
Authors: 李星晶, 张玉兰
Journal: BMJ (2007)

目的 了解上海地区中心医院对社区获得性肺炎收治的现状,以2006年中华医学会制订的社区获得性肺炎诊断和治疗指南中的病情评估标准来评价住院患者病情严重度,为我国社区获得性肺炎指南的推广应用提供循证医学依据.方法 以2005年1月至2006年9月我院呼吸科收治的137例社区获得性肺炎患者为对象,回顾性分析临床资料,对中国社区获得性肺炎诊疗指南中病情评估标准与肺炎严重度指数(PSI)分类的相关性进行比较研究;比较按中国社区获得性肺炎病情评估标准所分3组患者在住院时间、住院费用、抗生素静脉使用时间、危险因素数目、病死率等方面的差异.结果 中国社区获得性肺炎病情评估标准与PSI分类有很好的相关性(r=0.577,P＜0.01);按中国社区获得性肺炎病情评估标准,不符合住院标准组与符合住院标准组患者在住院时间、住院费用、抗生素静脉滴注时间等方面差异有统计学意义(P＜0.05);不符合住院标准组与重症肺炎组在住院时间、住院费用、危险因素数目、病死率方面差异有统计学意义(P＜0.01);符合住院标准组与重症肺炎组在住院费用、危险因素数目、病死率方面差异有统计学意义(P＜0.05).结论 中国社区获得性肺炎病情标准评估能准确判断患者病情严重度,应推广实施.PSI分级同样适用于中国人。
Outcome of men with HIV-associated germ cell cancer: Results from an international collaborative study.
Authors: Marcus Hentrich, Mark Bower, Gedske Daugaard, Annette Dieing, Markus Bickel, Massimiliano Berretta, Florian Lesmeister, Vindi Jurinovic, Albrecht Stöhr, Julia Heinzelbecker, Ivanka Krznaric, Klaus-Peter Dieckmann, Andrea Necchi, José Maroto, Jürgen Rockstroh, Margarida Brito Goncalves, Burkhard Joerg Otremba, Christian Hoffmann
Journal: Journal of Clinical Oncology (2020)

5053 Background: Previous studies showed that men with HIV-associated germ cell cancer (HIV-GCC) have a similar cancer-free outcome compared with their HIV-negative counterparts. However, the overall survival (OS) was inferior and little data is available on treatment and outcome of HIV-GCC in the era of combined antiretroviral therapy (cART). Methods: Men living with HIV aged ≥ 18 years (yrs) with a diagnosis of histologically proven GCC made from 01/1996 to 07/2018 were included. Primary outcomes were OS and progression-free survival (PFS). Secondary outcomes included characteristics of GCC and HIV-infection, treatment and causes of death. Results: Data of 89 men from 23 institutions and 6 countries with a total of 92 HIV-GCC (2 synchronous and 1 metachronous bilateral GCC) were analysed, among them 64 (70%) seminomas and 28 (30%) nonseminomas. 10/89 (11%) cases were primary extragonadal GCC. Median age was 36 yrs (range, 22-52) and median time from HIV to GCC diagnosis was 5 yrs (range, 0-29). Median CD4 count at GCC diagnosis was 420 cells/µl (range, 3-1503) and 83% of pts were on cART. Stage I disease was found in 44/80 (55%) gonadal GCC (metachronous bilateral case included). Of 46 cases with stage II/III/extragonadal GCC 78%, 17% and 4% were assigned to the IGCCCG good, intermediate and poor prognosis group, respectively. Of the 44 stage I cases, 22 (50%) were followed by active surveillance, and 11 (25%) received adjuvant chemotherapy (CT) or radiotherapy. Relapses occurred in 14 pts (6 from stage I, 8 in pts primary disseminated GCC) and CT was applied to 13/14 pts, of which 3 received high-dose CT. Overall, 12/89 (13%) pts have died. Causes of death were refractory GCC (n = 5), an AIDS-defining illness (n = 3) and other (n = 4). After a median follow-up of 6.5 yrs (range, 0.3-20.9), the 5- and 10-year PFS rate was 81% and 73%, and the 5- and 10-year OS rate was 91% and 85%, respectively. There were no significant differences between the good and intermediate prognosis group or between pts with CD4 counts &lt; 200/µl or ≥ 200/µl. Conclusions: The 5- and 10-year PFS and OS rates of men with HIV-GCC are similar to those reported for HIV-negative GCC. Pts with HIV-GCC should remain on cART and be managed in an identical fashion to HIV-negative pts.
Clinical characteristics of 12 cases of chronic active Epstein-Barr virus infection
Authors: Xiao-chun Shi, Hong-wei Fan, Wei Lü
Journal: BMJ (2013)

The medical records of all 12 patients diagnosed as chronic active Epstein-Barr virus (CAEBV) infection at our hospital were analyzed retrospectively. There were 7 males and 5 females with a median onset age of 28 years. CAEBV was characterized by fever, splenomegaly, hepatomegaly and lymphadenopathy, etc. The abnormalities of laboratory examination included liver dysfunction, thrombocytopenia, anemia and leucopenia. EBV-DNA detected by real-time polymerase chain reaction was (1.7×103-3.5×107) copies/μg DNA in peripheral blood mononuclear cell. Among them, the outcomes were death (n=5), lost to follow-up (n=2) and T cell lymphoma (n=1). It is necessary to improve our awareness of CAEBV infection because of its poor prognosis and high mortality.


Key words: 
Herpesvirus 4, human; Infection
Streamlining survivorship care plan (SCP) creation and delivery to primary care providers in poor, rural, and minority patients.
Authors: Bernard Tawfik, Shoshana Adler Jaffe, Jamina Oomen-Hajagos, Lisa Mohler, Inigo San Gil, Miria Adler Kano, Shawnia R Ryan, Janet Abernathy, Charles Wiggins, Andrew Sussman, Zoneddy R. Dayao
Journal: Journal of Clinical Oncology (2020)

e24181 Background: The number of cancer survivors is rapidly climbing due to increased screening and improved treatment. Survivorship Care Plans (SCPS) summarize the patients’ treatment and is a communication tool between oncologists and primary care physicians (PCP)s. Creation and delivery of the SCPs has been labor intensive and costly for many healthcare systems and a previous paper based system at our institution was ineffective. The University of New Mexico Comprehensive Cancer Center (UNMCCC) treats a unique population of lower socioeconomic status (SES) (poverty rate 19.7%), rural (22.6%) and minority (Native Americans and Hispanics constitute 10.4% and 48% of the population respectively) patients in a large rural state. Methods: Beginning March 2019, UNMCCC initiated a process for creation and delivery of SCPs through the Electronic Medical Record (EMR). EMRs are not designed to delivery SCPs to patients and PCPs, so EMR functions were creatively repurposed. Upon identification of eligible patients, providers would place an electronic SCP order through the EMR. Designated staff then partially completes the SCPs based on medical record review while the EMR imports demographics, PCP, cancer and stage. Then the EMR flags SCPs ready for delivery and the provider edits, approves and prints the SCP for the patient at the next encounter. Once printed, the EMR alerts medical records to send the SCP to the PCP via mail or EMR routing. Results: 282 SCPs were ordered, 222 (78.7%) were created and 86 (38.7%) given to patients after definitive therapy of Breast (77.9%), Colorectal (7.0%), Gynecological (9.3%) and Prostate Cancer (5.8%). Of 72 SCPs eligible to be sent to PCPs, 48 (66.7%) were successfully mailed or sent via EMR, 13 (18.1%) had PCP discrepancies, 6 (8.3%) had no PCP and 5 (6.9%) had PCPs in systems which do not accept unsolicited records. Conclusions: The UNMCCC cares for low SES, rural and minority patients and was able to create and deliver SCPs to a significant number of patients and PCPs. Future process steps will involve creating tailored SCPs for other diagnoses, resolving PCP discrepancy issues and creating an EMR alert for PCPs when they receive an SCP. Additionally, assessment of both patient and PCP perceptions is ongoing.
Clinicopathologic features and outcome of extra-nodal diffuse large B-cell lymphoma: An institutional experience from North India.
Authors: Sukesh C Nair, Ajay Gogia, Lalit Kumar, Atul Sharma, Ahitagni Biswas, Saumyaranjan Mallick
Journal: Journal of Clinical Oncology (2020)

e20079 Background: Primary extranodal diffuse large B cell lymphoma (DLBCL) forms upto 40-50% of all cases of DLBCL . Clinicopathological features and outcome of extranodal DLBCL patients especially in the rituximab era are scarce from developing countries. Methods: We carried out an ambispective analysis of newly diagnosed DLBCL patients (n = 417) over a period of 5 years (2014-2018).Of this total cohort 224 (53.7%) were found to have primary or predominant extranodal involvement. Prognostic factors were identified using Cox-regression analyses. Results: Median age was 50 years (18-86) with male female ratio of 2:1. B symptoms were seen in 48% patients and bulky disease in 39%. ECOG performance status of 0 or 1 was present in 50% and 63% presented with advanced disease. Bone was the most common site of extranodal involvement (32%) in our study followed by gastrointestinal tract ( 30%).Cell of origin (based on Hans algorithm) was available in 80% patients with Germinal center subtype (GCB) forming 44% and non-GCB forming 36% of all patients. Bone marrow involvement was present in 13 % patients. Low risk International Prognostic Index (IPI) was seen in 32 % and 41% were having intermediate risk IPI, the remaining being high risk. CHOP based treatment was used in 80 % of cases and rituximab was used in 76% of all cases. The overall response rate was 76% with a complete response rate (CR) of 65.5%. Presence of B-symptoms, central nervous system (CNS) involvement, non R-CHOP regimen and non-radiotherapy treatment protocols were associated with inferior CR rate. After a median follow up of 26 months, the 3-year event free survival and overall survival were 65 % and 82.7 % respectively. Involvement of specific extranodal sites (kidney, adrenals and CNS), high IPI score and use of non R-CHOP regimens were associated with poor EFS and OS on multivariate analysis Conclusions: This is one of the largest studies from India on extranodal DLBCL in the rituximab era. Involvement of specific extranodal sites, high IPI score and use of non R-CHOP regimens were associated with inferior survival.
A retrospective study of carboplatin and liposomal doxorubicin in patients with locally advanced or recurrent squamous cell carcinoma of the cervix.
Authors: LEI Chang, Zhongfu Yuan, Wanjia Tian
Journal: Journal of Clinical Oncology (2020)

e18021 Background: The efficacy and safety of the combination of carboplatin and liposomal doxorubicin was tested in in patients with locally advanced or recurrent cervical cancer. Methods: The combination of carboplatin (area under the concentration curve AUC = 5) and liposomal doxorubicin (starting dose, 40 mg/m 2 ) was administered intravenously every 28 days to 75 patients with locally advanced or recurrent cervical cancer to determine the drug efficacy and safety. Results: During the observation, all patients were received surgery or radiation before combination chemotherapy. 58 patients were assessable for response, and 12 patients were assessable for toxicity. During therapy, none patients required discontinuation of chemotherapy while only 2 patients needed dose reduction, because of side effect. The overall response rate was 77.3%, the median time to response was 8 weeks, the median duration of response was 24 weeks, and the median survival was 37 weeks. The most common adverse events with these patients included myelosuppression (69.0%), neutropenia (31.0%), anemia (23.0%), thrombocytopenia (21.0%) and neutropenic fever (11.0%). Conclusions: The combination of carboplatin and liposomal doxorubicin shows clinical efficacy and acceptable safety in patients with locally advanced or recurrent cervical carcinoma. It might provide a noval treatment for late stage cervical cancer.
The changing atlas of clinical research in cancer: Measuring accessibility to clinical trials.
Authors: Luca Mazzarella, Giulia Tini, Pammolli Fabio, Righetto Lorenzo, Giuseppe Curigliano, Pier Giuseppe Pelicci
Journal: Journal of Clinical Oncology (2020)

e14123 Background: The recent global economic growth produced dramatic social changes that impacted healthcare. Private industries, low and middle income countries increased their interest in clinical research. How these changes impact on accessibility to clinical trials has not been sufficiently studied, an issue becoming more relevant as trials increasingly constitute a relevant source of access to innovative drugs. Methods: We analyzed changes related to funding source, phase and locations involved in all interventional clinical trials on cancer extracted from clinicaltrials.gov from 2005 to 2019. We studied the evolution of accessibility to clinical trials on worldwide scale, by developing a family of indexes weighted on population, distance from the site location, numbers of trials. These indexes were also used to simulate different resource allocation models. Results: The absolute involvement of industry in clinical trials consistently increased (~6 fold over 2005), with a significant bias for phase 1 trials; however, its relative impact has globally remained the same. The geographical distribution of trial sites changed dramatically: some nations (China, Korea) increased their total number of trials 50 fold. The number of countries with ≥10 multicentric studies grew from 3 to 16. Our accessibility index (Table, relative increment on 2005 in parenthesis) shows that Asia had the highest improvement, with Korea and Taiwan as leading countries. The analysis captures significant trends associated with changing policies on trial conduct, such as the introduction in 2012 and abandonment in 2015 of centralized ethical committees in Brazil, or the introduction of EUdract in Europe in 2015. Simulations allowed to identify specific resource allocations to maximize accessibility. Conclusions: Accessibility to clinical trials is improving worldwide, but with important differences across continents and countries, which follow social, economic and political changes. Our accessibility indexes can inform national and continental healthcare/research policies, as they predict the impact of different resource allocation models, representing useful tools to facilitate access to innovative treatments. [Table: see text]
A phase Ib study of abemaciclib in combination with pembrolizumab for patients with hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) locally advanced or metastatic breast cancer (MBC) (NCT02779751): Interim results.
Authors: Hope S. Rugo, Peter Kabos, Joseph Thaddeus Beck, Michael Jon Chisamore, Anwar Hossain, Yanyun Chen, Sara M. Tolaney
Journal: Journal of Clinical Oncology (2020)

1051 Background: Abemaciclib is an orally administered, selective small molecule cyclin-dependent kinase (CDK)4 and 6 inhibitor, approved to treat HR+, HER2- MBC patients (pts) on a continuous twice daily dosing schedule as monotherapy or in combination with an aromatase inhibitor as initial endocrine based therapy or in combination with fulvestrant. Abemaciclib monotherapy increased tumor immunogenicity and synergized with anti-PD-1 to boost antitumor efficacy in murine models. Here we report safety and antitumor activity of abemaciclib plus pembrolizumab in HR+, HER2- MBC pts. Methods: This multicenter, nonrandomized, open-label, multi-cohort phase Ib study of abemaciclib plus pembrolizumab enrolled a cohort of endocrine resistant HR+, HER2- MBC pts who had received 1 or 2 prior chemotherapy regimens for MBC. No prior CDK4/6 inhibitor was allowed. Patients received 150mg abemaciclib orally every 12 hours plus pembrolizumab 200mg IV on day 1 every 21 days. Primary objective was to characterize safety of the abemaciclib plus pembrolizumab combination. Secondary objectives included objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). Results: Of 28 pts enrolled, 15 (54%) received 1 line and 10 (36%) 2 lines of prior systemic chemotherapy in the locally advanced/metastatic setting. Safety of the combination was generally consistent with known side effects of abemaciclib and pembrolizumab and was generally manageable. Grade 3/4 adverse events in &gt;2 pts included neutropenia (8 pts/29%), AST increase (5 pts/18%), diarrhea, and ALT increase (3 pts/11% each). Eight pts had confirmed partial response (29% ORR), and disease control rate (complete response [CR]+partial response [PR]+stable disease [SD]) was 82%. Clinical benefit rate (CR+PR+SD persisting for ≥6 months) was 46%. Median PFS and OS were 8.9 months (95% CI 3.9, 11.1) and 26.3 months (95% CI 20.0, 31.0), respectively. Conclusions: Combination of abemaciclib plus pembrolizumab demonstrated a generally tolerable safety profile with numerically higher rate of transaminase elevations than reported for the individual treatments. Compared to historical data for abemaciclib monotherapy in a similar pt population, a numerically higher but not obviously different ORR, PFS, and OS was observed. Clinical trial information: NCT02779751 .
A retrospective study on the incidence and risk factors ofsevere hypoglycemia in primary care
Authors: 陈丽英, 方力争
Journal: BMJ (2013)

目的
调查初级保健中严重低血糖症的发生率和危险因素。该研究中严重低血糖症指低血糖症伴昏迷以及需要注射葡萄糖或胰高血糖素者。


方法
对在德国接受初级保健治疗的糖尿病患者进行了一个横断面的回顾性研究。参加Deutsche BKK健康保险计划的所有保险人被纳入研究，其中1型糖尿病患者373例，2型糖尿病患者4481例。1型糖尿病组中女性155例(42%)，年龄(49±16)岁，病程(20±13)年，BMI(28±6)kg/m2，糖化血红蛋白(GHb)(7.1±1.5)%；GHb≤7%者263例(71%)，GHb≥8.5%者48例(13%)。2型糖尿病组中女性1979例(44%)，年龄(66±10)岁，病程(8±7)年，BMI(30±5)kg/m2，GHb (6.6±1.3)%；GHb≤7%者3747例(84%)，GHb≥8.5%者360例(8%)；胰岛素治疗者1175例(26%)。


结果
严重低血糖症在1型糖尿病患者中的发生率为每年1.3%(95%CI：0.4～3.1)。接受胰岛素治疗的2型糖尿病患者严重低血糖症发生率为每年0.9%(95%CI：0.5～1.7)，没有接受胰岛素治疗者严重低血糖症发生率为每年0.3%(95%CI：0.1～0.6)。1型糖尿病和2型糖尿病患者严重低血糖症事件的发生率分别为每人每年2%和1%。低BMI、低GHb、胰岛素治疗和女性是严重低血糖症的危险因素。


结论
在初级卫生保健工作中，糖尿病患者血糖可以得到良好控制，严重低血糖症很少发生。由于严重低血糖症的发生率很低，所以它不是初级保健工作中评价糖尿病治疗效果和质量的合适指标。
就诊居民对社区卫生服务的利用及满意度调查
Authors: 袁兆康, 周小军, 万红, 肖云昌, 操秋阳, 蔡燕玲, 邓大安, 洪定香
Journal: BMJ (2006)

采用偶遇法调查就诊居民对赣州市章贡区社区卫生服务的利用及其评价.结果显示216名居民到社区卫生服务机构就诊的目的中诊疗占81.48%,开药占73.61%;选择社区卫生服务机构就诊的原因中方便占64.35%,态度好占61.11%;就诊居民对社区卫生服务机构的服务态度、医生技能、方便程度等10个方面的总满意度达73.38%;居民首诊地点的选择与医疗保障制度有一定关联。