Balamuth Fran, Zhao Huaqing, Mollen Cynthia
Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Pediatr Emerg Care. 2010 Feb;26(2):85-92. doi: 10.1097/PEC.0b013e3181cdf349.
To assess the utility of an abbreviated teaching tool (ATT) in improving emergency medicine pediatricians' knowledge of the diagnosis and the treatment of pelvic inflammatory disease (PID).
An 18-question internet-based survey, which included questions about the diagnosis and the treatment of PID, was administered to members of the American Academy of Pediatrics Section on Emergency Medicine. Participants were randomized to receive either a weblink to the Centers for Disease Control and Prevention (CDC) sexually transmitted disease treatment guidelines (weblink group) or a 1-page ATT that summarized the CDC guidelines (ATT group) to assist with completion of the survey. We compared the accuracy of responses between the 2 groups.
Two hundred thirty-seven subjects responded to the survey (109 from the weblink group and 128 from ATT group). There were no significant differences between the groups with respect to sex, geographic location, practice setting, years of experience, or reported frequency of recent PID diagnoses. Ninety-seven percent of the ATT group correctly identified the appropriate antibiotic regimen in compliance with the CDC guidelines compared with 61% of the weblink group (OR, 19.4; 95% confidence interval, 6.6-76.9); the ATT group was also more likely to correctly identify appropriate treatment options overall (OR, 9.6; 95% confidence interval, 4.9-19.3).
Although the overall PID knowledge in our sample was low, the physicians with access to a 1-page teaching tool summarizing the CDC treatment recommendations for PID performed significantly better when asked questions involving PID treatment as compared with providers with access to the CDC Web site. Further studies should investigate whether access to a similar tool can improve patient care.
评估一种简化教学工具(ATT)在提高急诊医学儿科医生对盆腔炎性疾病(PID)诊断和治疗知识方面的效用。
对美国儿科学会急诊医学分会成员进行了一项基于网络的包含18个问题的调查,这些问题涉及PID的诊断和治疗。参与者被随机分为两组,一组接收疾病控制与预防中心(CDC)性传播疾病治疗指南的网页链接(网页链接组),另一组接收总结CDC指南的1页ATT(ATT组),以协助完成调查。我们比较了两组回答的准确性。
237名受试者回复了调查(网页链接组109名,ATT组128名)。两组在性别、地理位置、执业环境、工作年限或近期报告的PID诊断频率方面无显著差异。ATT组97%的人根据CDC指南正确识别了合适的抗生素治疗方案,而网页链接组为61%(比值比,19.4;95%置信区间,6.6 - 76.9);ATT组总体上也更有可能正确识别合适的治疗选择(比值比,9.6;95%置信区间,4.9 - 19.3)。
尽管我们样本中对PID的总体知识水平较低,但与可访问CDC网站的医生相比,可获取1页总结CDC对PID治疗建议的教学工具的医生在被问及涉及PID治疗的问题时表现明显更好。进一步的研究应调查获取类似工具是否能改善患者护理。