医学生课程中急诊室的主要投诉类别。

ED chief complaint categories for a medical student curriculum.

作者信息

Kuykendal Adam R, Tintinalli Judith, Biese Kevin

机构信息

Department of Internal Medicine, Northwestern McGaw Medical Center, Chicago, IL 60610, USA.

出版信息

Int J Emerg Med. 2008 Jun;1(2):139-43. doi: 10.1007/s12245-008-0027-1. Epub 2008 Jun 5.

DOI:10.1007/s12245-008-0027-1

PMID:19384667

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2657248/

Abstract

BACKGROUND

It is important to stimulate the interest of all medical students in emergency medicine to further its growth nationally and internationally. Students focused on other specialties can benefit from exposure to the more common, less acute problems seen in the emergency department (ED).

AIMS

We developed a categorization system for chief complaints (CC) in an academic ED fast track (FT) area, so that a curriculum based upon actual CC and clinical experience could be designed for learners.

METHODS

Primary (first) FTCCs were obtained from the ED electronic record of an academic medical center from 1 to 10 July 2006 and 1 to 10 February 2007. Category definitions were developed, and CCs were collapsed into clinically coherent groups. Inter-rater reliability was assessed, and CC categories were compared for the two study periods. The study was exempted by the University Institutional Review Board.

RESULTS

In the July data set, 493 CCs were placed into 8 categories which captured 96.3% of CCs: pain 32.3%, injury 26.6%, infection 15%, psychiatric 8.1%, miscellaneous 6.1% (those with a frequency of </= 2%), nurse only visit 5.5%, eye 4.3% and rash 2.2%. The weighted kappa for CC categorization between two observers was 0.8980 (95% confidence interval: 0.8638-0.9322). In the February data set, refinements with 454 CCs resulted in categorization of 96.9% of the CCs into the same 8 categories with 53 subcategories. The distribution of the major categories was similar in July and February (p = 0.13).

CONCLUSIONS

The FTCC categorization was valid and reliable and can guide curriculum development for learners in an academic setting.

摘要

背景

激发所有医学生对急诊医学的兴趣对于其在国内和国际上的进一步发展至关重要。专注于其他专业的学生可以从接触急诊科（ED）中更常见、不太紧急的问题中受益。

目的

我们为学术性急诊科快速通道（FT）区域的主要诉求（CC）开发了一种分类系统，以便为学习者设计基于实际CC和临床经验的课程。

方法

从一所学术医疗中心的急诊科电子记录中获取2006年7月1日至10日以及2007年2月1日至10日的主要（首次）FTCC。制定类别定义，并将CC合并为临床相关的组。评估评分者间信度，并比较两个研究时期的CC类别。该研究获得了大学机构审查委员会的豁免。

结果

在7月的数据集中，493个CC被分为8类，涵盖了96.3%的CC：疼痛32.3%、损伤26.6%、感染15%、精神科8.1%、其他6.1%（频率≤2%的那些）、仅护士就诊5.5%、眼部4.3%和皮疹2.2%。两名观察者之间CC分类的加权kappa为0.8980（95%置信区间：0.8638 - 0.9322）。在2月的数据集中，对454个CC进行细化后，96.9%的CC被分为相同的8类，包含53个子类别。7月和2月主要类别的分布相似（p = 0.13）。