Evidence-Based Strategies Improve Assessment of Pediatric Bipolar Disorder by Community Practitioners
Evidence-Based Strategies Improve Assessment of Pediatric Bipolar Disorder by Community Practitioners
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DOI：
10.1037/a0022506
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发表时间：
2011-04-01
影响因子：
1.5
通讯作者：
Youngstrom, Jennifer Kogos
中科院分区：
文献类型：
--
作者：
Jenkins, Melissa M.;Youngstrom, Eric A.;Youngstrom, Jennifer Kogos
儿童双相情感障碍（PBD）的误诊已成为一个主要的公共卫生问题。现有的循证评估（EBA）策略是否有助于提高诊断准确性？临床医生是否愿意在实践中考虑这些策略？本研究的目的是记录在何种程度上使用EBA决策工具-概率诺模图-提高了临床医生对家族史和检测数据的解释，并检查诺模图技术对临床医生的可接受性。美国和加拿大参加继续教育研讨会的600多名临床医生接受了使用诺模图的培训。参与者首先使用临床判断，然后使用列线图来估计临床小插曲中的青年患有双相情感障碍的概率。对临床医生进行使用列线图评估PBD的简短培训（少于30分钟），提高了诊断的准确性、一致性和一致性。大多数临床医生赞同在实践中使用诺模图。EBA决策辅助工具，如列线图，可能会导致过度诊断的显着减少，并帮助临床医生发现真正的PBD病例。
The misdiagnosis of pediatric bipolar disorder (PBD) has become a major public health concern. Would available evidence-based assessment (EBA) strategies help improve diagnostic accuracy and are clinicians willing to consider these strategies in practice? The purpose of the present study was to document the extent to which using an EBA decision tool-a probability nomogram-improves the interpretation of family history and test data by clinicians and to examine the acceptability of the nomogram technique to clinicians. Over 600 clinicians across the U.S. and Canada attending continuing education seminars were trained to use the nomogram. Participants estimated the probability that a youth in a clinical vignette had bipolar disorder, first using clinical judgment and then using the nomogram. Brief training of clinicians (less than 30 minutes) in using the nomogram for assessing PBD improved diagnostic accuracy, consistency, and agreement. The majority of clinicians endorsed using the nomogram in practice. EBA decision aids, such as the nomogram, may lead to a significant decrease in overdiagnosis and help clinicians detect true cases of PBD.