この子供は急性中耳炎ですか?
Russell Rothman1, Thomas Owens, David L Simel
1Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn 37232, USA. russell.rothman@vanderbilt.edu
JAMA
|September 25, 2003
まとめ
子どもにおける急性中耳炎 (AOM) の正確な診断は,特定の身体検査の結果に依存します. 空気性オトスコーピーの曇り,膨らみ,または不動の鼓膜は,AOMの重要な指標です.
科学分野:
- 小児医学は,小児科の医学である.
- 耳鼻喉科 (Otorhinolaryngology) は,耳鼻喉科 (Otorhinolaryngology) を専門とする医療機関である.
- 診断精度に関する研究 診断精度に関する研究
背景:
- 急性中耳炎 (AOM) は,小児科で頻繁に発生する病気です.
- 正確なAOM診断は,適切な管理とフォローアップに不可欠です.
研究 の 目的:
- 患者の病歴の診断の正確性と,小児におけるAOMの身体検査に関する文献を体系的にレビューする.
- AOMの診断における様々な症状と徴候の精度と正確さを決定する.
主な方法:
- AOMの診断精度に関する英語研究 (1966-2002) のMEDLINEと文献を検索しました.
- 小児におけるAOMの履歴または身体検査に関するオリジナルのデータを含む研究が含まれています.
- 症状と徴候の確率比 (LRs) を計算し,必要に応じてバイアスを調整する.
主要な成果:
- 耳の痛みは最も有用な症状である (陽性LR,3.0-7.3).
- 曇った (調整されたLR,34),膨らんだ (調整されたLR,51),または動かない (調整されたLR,31) tympanic 膜は,AOM を非常に示すものです.
- 鮮明に赤い耳膜は有益である (調整されたLR,8.4),正常な色はAOMの欠如を示唆する (調整されたLR,0.2).
結論:
- 研究の限界にもかかわらず,特定の物理的発見はAOMの診断にとって最も価値があります.
- 曇った,膨らんだ,または不動の tympanic 膜は,最も強力な指標です.
- tympanic 膜の赤腫も有用な兆候であり,正常な色はAOMの可能性を下げます.
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