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在儿科急诊医学中坚持"明智选择"的建议
Tara F Corcoran1, Sriram Ramgopal1, Jennifer A Hoffmann1
1Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Annals of emergency medicine
|March 18, 2025
概括
低值测试在儿科急诊室经常发生,在近五分之一的访问中发生. 这些测试的速度与急诊室的数量不一致,挑战了广泛的建议.
科学领域:
- 儿科急救医学 儿科急救医学
- 医疗保健服务研究 医疗服务研究
- 改善临床质量 改善临床质量
背景情况:
- 选择明智的指导方针旨在减少儿科急诊医学中低价值测试.
- 低值测试的变化可能与急诊室 (ED) 的经验和患者数量有关.
- 了解这种关系对于优化测试实践至关重要.
研究的目的:
- 根据其年度患者数量,比较美国儿科急诊室低值检测的频率.
- 评估ED体积与特定儿科疾病低值测试发生的相关性.
主要方法:
- 一项横截面研究分析了从2014年至2020年间在8个州的560万次儿科访问 (18岁以下).
- 包括诊断:呼吸道疾病,心理/行为健康,发作,便秘和呼吸道病毒疾病.
- ED量分类 (低到高);通过程序代码识别低值测试;用于分析的后勤回归.
主要成果:
- 在所有分析的儿科ED遭遇的19.3%中,进行了低值测试.
- 测试率因ED体积而异:12.2% (低体积) 到23.1% (中等体积).
- 低容量ED显示精神健康,便秘和病毒性疾病的发病率较低;高容量ED显示呼吸系统疾病和发作的发病率较低.
结论:
- 近五分之一的针对特定疾病的儿科急救诊所访问涉及低值测试.
- 在不同儿科疾病中,ED体积和低值测试之间的关联不一致.
- 可能需要进一步的研究来完善减少基于ED特征的低值测试的策略.
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