Large Variation in Clinical Practice amongst Pediatricians in Treating Children with Recurrent Abdominal Pain / 대한소아소화기영양학회지
Pediatric Gastroenterology, Hepatology & Nutrition
;
: 225-232, 2019.
Article
in English
| WPRIM
| ID: wpr-741842
ABSTRACT
PURPOSE:
To evaluate intra- and inter-observer variability and guideline adherence amongst pediatricians in treating children aged between 4 and 18 years referred with recurrent abdominal pain (RAP) without red flags.METHODS:
The first part of the study is a retrospective single-center cohort study. The diagnostic work-ups of eight pediatricians were compared to the national guidelines. Intra- and inter-observer variability were examined by Cramer's V test. Intra-observer variability was defined as the amount of variation within a pediatrician and inter-observer variability as the amount of variation between pediatricians in the application of diagnostic work-up in children with RAP. Prospectively, the same pediatricians were requested to provide a report on their management strategy with a fictitious case to prove similarities in retrospective diagnostic work-up.RESULTS:
A total of 10 patients per pediatrician were analyzed. Retrospectively, a (very) weak association between pediatricians' diagnostic work-ups was found (0.22), which implies high inter-observer variability. The association between intra-observer diagnostic was moderate (range, 0.35–0.46). The Cramer's V of 0.60 in diagnostic work-up between pediatricians in the fictitious case implied the presence of a moderately strong association and lower inter-observer variability than in the retrospective study. Adherence to the guideline was 66.8%.CONCLUSION:
We found a high intra- and inter-observer variability and moderate guideline adherence in daily clinical practice amongst pediatricians in treating children with RAP in a teaching hospital.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Abdominal Pain
/
Observer Variation
/
Prospective Studies
/
Retrospective Studies
/
Cohort Studies
/
Guideline Adherence
/
Hospitals, Teaching
Type of study:
Etiology study
/
Practice guideline
/
Incidence study
/
Observational study
/
Risk factors
Limits:
Child
/
Humans
Language:
English
Journal:
Pediatric Gastroenterology, Hepatology & Nutrition
Year:
2019
Type:
Article
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