Schwarz Jessie Naomi, Monti Amy, Savelli-Castillo Ilse, Nelson Linda P
Department of Pediatric Dentistry, Children's Hospital, Boston, Mass, USA.
Pediatr Dent. 2004 Sep-Oct;26(5):433-9.
Accurate reporting of medical history information is essential to provide safe and successful dental treatment to children. The purpose of this study was to evaluate the accuracy of health histories reported by parents/guardians of pediatric patients presenting for dental treatment by comparing them to the histories provided in the child's medical chart.
Data collection from the dental record was performed using the medical history questionnaire from the child's first visit as the data source. Data collected focused on knowledge of the child's medical conditions, current medications, allergies, immunization status, and need for prophylactic antibiotics. Corresponding data were collected from the child's medical chart. Statistical analysis included kappa analysis and calculation of sensitivity, specificity, and failure-to-report rates.
The study group consisted of 226 children (99 girls, 127 boys), with a mean age of 10.35 years. The patients were divided into 2 groups based on their medical status (healthy vs medically compromised). For the medically compromised children, parents had high sensitivity reporting rates (>75% sensitivity) for only 2 out of the 9 medical categories. For both groups, <50% of the medicine, allergy, and need for prophylaxis categories had sensitivity rates above 75%. Failure-to-report rates of 40% to 60% were common, with some as high as 80%. Weighted failure-to-report rates were consistently higher for medically compromised children compared to healthy children.
Parents/guardians of children presenting for dental treatment are not always able to accurately report vital medical history information. Therefore, pediatric dentists need to more closely examine the dental health questionnaire and make every attempt to obtain accurate information to provide appropriate care for each patient.
准确报告病史信息对于为儿童提供安全且成功的牙科治疗至关重要。本研究的目的是通过将儿科患者家长/监护人报告的健康史与儿童病历中提供的病史进行比较,来评估其准确性。
以儿童首次就诊时的病史问卷作为数据源,从牙科记录中收集数据。收集的数据集中在儿童的健康状况、当前用药情况、过敏史、免疫接种状况以及预防性抗生素的需求。从儿童病历中收集相应数据。统计分析包括kappa分析以及敏感性、特异性和漏报率的计算。
研究组由226名儿童组成(99名女孩,127名男孩),平均年龄为10.35岁。根据医疗状况将患者分为两组(健康组与健康受损组)。对于健康受损的儿童,家长在9个医疗类别中只有2个的高敏感性报告率(>75%敏感性)。对于两组而言,药物、过敏和预防需求类别中,<50%的敏感性率高于75%。40%至60%的漏报率很常见,有些高达80%。与健康儿童相比,健康受损儿童的加权漏报率始终更高。
前来接受牙科治疗的儿童的家长/监护人并不总是能够准确报告重要的病史信息。因此,儿科牙医需要更仔细地检查牙科健康问卷,并尽一切努力获取准确信息,以便为每位患者提供适当的护理。