Stecher Dawn S, Adelman Raymond, Brinkman Traci, Bulloch Blake
Department of Emergency Medicine, Phoenix Children's Hospital, Phoenix, AZ 85016, USA.
Pediatr Emerg Care. 2008 Feb;24(2):71-4. doi: 10.1097/PEC.0b013e318163db4d.
The purpose of this study was to ascertain whether either parental recall or a state immunization registry was as accurate as the medical record in determining immunization status in the emergency department (ED).
A convenience sample of children younger than 5 years who presented to the ED between July 2004 and May 2005 were enrolled prospectively. After obtaining informed consent, parents were asked about their child's immunization status. All children then had their immunization data accessed in the Arizona State Immunization Information System. The information obtained from the state registry, as well as the information from the parental interview, was then compared with the information on the medical record obtained from the primary care physician (PCP). Data were analyzed using simple descriptive statistics.
A total of 332 children were enrolled in the study. A total of 302 (91%) children enrolled were found in the state database, and 222 (74%) of these had a medical record available for comparison. The database agreed with the PCP record in 130 (59%) cases; parental report agreed with the PCP record in 149 (62%) cases.
Although most children can be found in the state immunization registry, it seems to be similar in accuracy to parental recall of immunization status when each is compared with the medical record. This may have been due to either underreporting of immunizations from the community or a delay in updating the state database. At this time, neither parental recall nor the database would accurately determine a child's immunization status during an ED visit.
本研究旨在确定在急诊科(ED)确定免疫接种状态时,家长回忆或国家免疫接种登记系统是否与病历记录一样准确。
前瞻性纳入2004年7月至2005年5月期间到急诊科就诊的5岁以下儿童的便利样本。在获得知情同意后,询问家长其孩子的免疫接种状态。然后所有儿童的免疫接种数据均从亚利桑那州免疫接种信息系统中获取。将从国家登记系统获得的信息以及家长访谈得到的信息与从初级保健医生(PCP)处获得的病历信息进行比较。使用简单描述性统计分析数据。
共有332名儿童纳入本研究。在国家数据库中找到了302名(91%)纳入研究的儿童,其中222名(74%)有可供比较的病历。数据库与初级保健医生记录在130例(59%)病例中一致;家长报告与初级保健医生记录在149例(62%)病例中一致。
尽管大多数儿童可在国家免疫接种登记系统中找到,但与病历记录相比时,其准确性似乎与家长对免疫接种状态的回忆相似。这可能是由于社区免疫接种报告不足或国家数据库更新延迟所致。目前在急诊科就诊期间,家长回忆和数据库均无法准确确定儿童的免疫接种状态。