Accuracy of clinical assessment of heart murmurs by office based (general practice) paediatricians
Accuracy of clinical assessment of heart murmurs by office based (general practice) paediatricians
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DOI：
10.1136/adc.81.5.409
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发表时间：
1999-11-01
影响因子：
5.2
通讯作者：
McCrindle, BW
中科院分区：
文献类型：
--
作者：
Haney, I;Ipp, M;McCrindle, BW
目的-为了确定诊断的准确性，体检的办公室为基础的（全科）儿科医生在心脏murs. Design的评价，每30个办公室为基础的儿科医生盲目检查一个随机样本的儿童杂音（其中43%是病理性的）。灵敏度和特异性进行了计算，并与儿科医生的characteristics.Results-Mean（SD）的敏感性为82（24）%，平均特异性为72（24）%，在区分病理性和无害杂音，与进一步调查要求为54%的评估。增加转诊策略将使平均敏感性增加至87（20）%，特异性增加至98（8）%。诊断的准确性是没有显着相关的儿科医生的年龄，教育或实践的特点，但与转诊的做法和信心assessment. Conclusions诊断准确性的临床评估心脏：杂音办公室为基础的儿科医生是次优，教育策略，需要提高准确性，减少不必要的转诊和误诊。
Aim-To determine the diagnostic accuracy of physical examination by office based (general practice) paediatricians in the evaluation of heart murmurs.Design-Each of 30 office based paediatricians blindly examined a random sample of children with murmurs (43% of which were pathological). Sensitivity and specificity were calculated and were related to paediatricians' characteristics.Results-Mean (SD) sensitivity was 82 (24)% with a mean specificity of 72 (24)% in differentiating pathological from innocent murmurs, with further investigations requested for 54% of assessments. The addition of a referral strategy would have increased mean sensitivity to 87 (20)% and specificity to 98 (8)%. Diagnostic accuracy was not significantly related to the paediatricians' age, education or practice characteristics, but was related to referral practices and confidence in assessment.Conclusions-Diagnostic accuracy of clinical assessment of heart :murmurs by office based paediatricians is suboptimal, and educational strategies are needed to improve accuracy and reduce unnecessary referrals and misdiagnosis.