儿童呼吸道检测结果的可靠性
Sriram Ramgopal1, Jennifer K Saper2, James R Rudloff3
1Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Hospital pediatrics
|August 24, 2025
概括
儿童急诊医生在识别异常的儿童呼吸声方面表现不佳,除了正常的呼吸声外. 这表明需要改进的方法来准确诊断儿童的呼吸系统疾病.
科学领域:
- 儿童紧急医疗
- 呼吸系统诊断
- 医疗教育
背景情况:
- 准确解释儿科辅助检查结果对于诊断呼吸系统疾病至关重要.
- 在医生之间解释这些声音的可靠性尚未得到充分证实.
- 解释的变化可能导致诊断延迟或错误.
研究的目的:
- 评估儿科紧急医疗 (PEM) 医生之间的儿科辅助研究结果的可靠性.
- 确定具有低或可接受可靠性的特定研究结果.
- 探索影响可靠性的因素,例如多年的经验.
主要方法:
- 在美国6个学术PEM部门进行了多中心调查.
- 医生们收听了15段儿童听力学声音的录音.
- 根据地点和经验分层计算Fleiss' kappa (κ) 来评估评价者之间的可靠性.
主要成果:
- 只有识别正常的呼吸声音 (κ = 0.46) 达到可靠性值.
- 对 (κ = 0. 32),喘息 (κ = 0. 25), (κ = 0. 15), (κ = 0. 15) 的可靠性较差.
- 对于正常的呼吸声 (0. 85) 准确度最高,根据医生的经验,有一些变化.
结论:
- 大多数儿科辅导发现的解释中存在显著的interrater变异性.
- 正常的呼吸声识别显示可接受的可靠性,但其他偶然的声音没有.
- 需要加强培训和标准化方法来准确解释儿童呼吸声.
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