Comparison of Aerodigestive and Nonaerodigestive Provider Responses to Clinical Case Vignettes
| Autor: | Dana I. Williams, Suzanna Hirsch, Eric H. Chiou, Joel A. Friedlander, Dominique Levesque, Jose M. Garza, Paul Mitchell, Meredith Lind, Sari Acra, Rachel Rosen, Hayat M. Mousa, Valeria C. Cohran, Melanie Greifer, Jason E. Dranove, Rinarani Sanghavi, Lindsey Gumer, Vrinda Bhardwaj, Diana G. Lerner, Benjamin D. Gold, Lusine Ambartsumyan |
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| Rok vydání: | 2021 |
| Předmět: |
Canada
medicine.medical_specialty Multivariate analysis Adolescent Digestive System Diseases Respiratory Tract Diseases Subspecialty Pediatrics Feeding difficulty 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires 030225 pediatrics medicine Humans 030212 general & internal medicine Practice Patterns Physicians' Child Pediatric gastroenterology Practice Patterns Nurses' Practice patterns business.industry Gastroenterology Infant Newborn Infant United States Child Preschool Family medicine Pediatrics Perinatology and Child Health Linear Models Clinical case business Empiric therapy Specialization |
| Zdroj: | The Journal of Pediatrics. 232:166-175.e2 |
| ISSN: | 0022-3476 |
| Popis: | To evaluate differences in practice patterns between aerodigestive and nonaerodigestive providers in pediatric gastroenterology when diagnosing and treating common aerodigestive complaints.A questionnaire comprised of clinical vignettes with multiple-choice questions was distributed to both aerodigestive and nonaerodigestive pediatric gastroenterologists. Vignettes focused on management of commonly encountered general gastroenterology and aerodigestive issues, such as gastroesophageal (GE) reflux, aspiration, and feeding difficulties. Tests of equal proportions were used to compare rates of testing and empiric therapy within and across groups. Multivariate analysis was used to assess differences in response rates between aerodigestive and nonaerodigestive providers.A total of 88 pediatric gastroenterologists from 18 institutions completed the questionnaire. There were 35 aerodigestive gastroenterology providers and 53 nonaerodigestive gastroenterology providers. The nonaerodigestive group included 31 general gastroenterologists and 22 providers with self-identified subspecialty gastroenterology expertise. Aerodigestive specialists were more likely than nonaerodigestive gastroenterologists to pursue testing over empiric therapy in cases involving isolated respiratory symptoms (P .05); aerodigestive providers were more likely to recommend pH-impedance testing, videofluoroscopic swallow studies, and upper gastrointestinal barium study (P .05 for each test) depending on the referring physician. For vignettes involving infant GE reflux, both groups chose empiric treatments more frequently than testing (P .001), although aerodigestive providers were more likely than nonaerodigestive providers to pursue testing like upper gastrointestinal barium studies (P .05).Although some practice patterns were similar between groups, aerodigestive providers pursued more testing than nonaerodigestive providers in several clinical scenarios including infants with respiratory symptoms and GE reflux. |
| Databáze: | OpenAIRE |
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