Do parents and physicians differ in making decisions about acute otitis media?

Area of Science:

• Pediatric Health Decision-Making
• Comparative Health Services Research
• Evidence-Based Medicine

Background:

• Acute otitis media (AOM) is a common childhood illness requiring careful diagnostic and treatment decisions.
• Understanding how parents and physicians perceive AOM and its management is crucial for effective healthcare.
• Previous research has not extensively compared parental and physician decision-making processes for AOM.

Purpose of the Study:

• To investigate and compare the decision-making processes of parents and physicians regarding the diagnosis and treatment of acute otitis media in children.
• To identify differences or similarities in how parents and physicians evaluate clinical cues and choose management strategies for potential AOM cases.

Main Methods:

• Utilized questionnaires presenting hypothetical pediatric AOM scenarios to assess diagnostic probabilities and treatment choices.
• Included convenience samples of US and French physicians (generalists, pediatricians) and parents.
• Employed multiple linear regression to derive individual and group judgment policies, analyzing the weight given to various clinical cues.

Main Results:

• Mean judged probabilities for AOM were similar across US/French physicians and parents (around 50-52.5%).
• Antibiotic treatment rates did not significantly differ between physicians and parents (ranging from 45% to 53%).
• Both groups prioritized physical examination findings for diagnosis and treatment decisions, with parents showing less emphasis on cues related to parental concerns.

Conclusions:

• US and French parents demonstrated judgment and treatment choices highly consistent with those of physicians for AOM.
• Parents appear capable of adopting a physician's perspective in AOM management.
• Both parents and physicians exhibited selective antibiotic use, indicating a shared understanding of appropriate treatment.