Current management and referral patterns of pediatricians for acute otitis media
Current management and referral patterns of pediatricians for acute otitis media
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DOI：
10.1016/j.ijporl.2018.06.036
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发表时间：
2018-10-01
影响因子：
1.5
通讯作者：
Carr, Michele M.
中科院分区：
文献类型：
--
作者：
Shah-Becker, Shivani;Carr, Michele M.
目的：美国儿科学会(AAP)发布了一份针对急性中耳炎(AOM)治疗的循证临床实践指南，最近一次修订是在2013年。这项研究旨在评估当前的执业模式以及它们与已公布的指南的比较。方法：将一份针对2013年AAP AOM指南中包含的主题的11个问题的调查邮寄给196名执业儿科医生。统计分析采用卡方检验和方差分析。结果：收回调查问卷76份(38%)。75%的受访者是团体执业(非学术)，83%的受访者执业11年或更长时间。93%的人是AAP的成员。46%的受访儿科医生每天至少使用一次气动耳镜和/或鼓室导纳来帮助诊断AOM，而28%的医生从不这样做。对于2岁以下的单侧非重度AOM，15%的被调查者会选择密切观察而不是抗生素；50%的被调查者会选择对2岁以上的儿童进行密切观察。75%的被调查者会因AOM复发而转诊到耳鼻咽喉科。在住院医师培训期间，基于执业类型、执业年限或耳鼻咽喉科经验的回答没有显著差异。结论：目前儿科医生的执业和转诊模式与AAP 2013年的指南不一致。作为咨询外科医生，耳鼻喉科医生应该了解相关专业的治疗方案，这些方案可能会对他们的执业产生影响。
Objective: The American Academy of Pediatrics (AAP) has published an evidence-based clinical practice guideline for the management of acute otitis media (AOM), most recently revised in 2013. This study aims to assess current practice patterns and how they compare to the published guideline.Methods: An 11 question survey addressing topics included in the 2013 AAP AOM guidelines was mailed to 196 practicing pediatricians. Statistical analysis was performed using Chi-square and ANOVA testing.Results: 76 (38%) completed surveys were returned. 75% of respondents were in group practice (non-academic) and 83% were in practice 11 years or more. 93% were members of the AAP. 46% of responding pediatricians use pneumatic otoscopy and/or tympanometry at least once a day to aid in the diagnosis of AOM, while 28% never do. 15% of respondents would choose close observation over antibiotics in a child under the age of 2 years with unilateral non-severe AOM while 50% would choose close observation in a child over age 2. 75% would make a referral to Otolaryngology for recurrent AOM. No significant differences were noted in responses based on practice type, years in practice, or Otolaryngology experience during residency training.Conclusions: Current pediatrician practice and referral patterns for AOM are not consistent with 2013 Guidelines from the AAP. As consulting surgeons, Otolaryngologists should have knowledge of management protocols in related specialties that can have an impact on their practice.