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生长监测:欧洲初级保健儿科医生当前实践情况的调查。

Growth monitoring: a survey of current practices of primary care paediatricians in Europe.

机构信息

Institut National de la Santé et de la Recherche Médicale, Centre for research in Epidemiology and Population Health, U1018, Lifelong Epidemiology of Diabetes, Obesity and Kidney Diseases Team, Villejuif, France.

出版信息

PLoS One. 2013 Aug 5;8(8):e70871. doi: 10.1371/journal.pone.0070871. Print 2013.

Abstract

OBJECTIVE

We aimed to study current practices in growth monitoring by European primary care paediatricians and to explore their perceived needs in this field.

METHODS

We developed a cross-sectional, anonymous on-line survey and contacted primary care paediatricians listed in national directories in the 18 European countries with a confederation of primary care paediatricians. Paediatricians participated in the survey between April and September 2011.

RESULTS

Of the 1,198 paediatricians from 11 European countries (response rate 13%) who participated, 29% used the 2006 World Health Organization Multicentre Growth Reference Study growth charts, 69% used national growth charts; 61% used software to draw growth charts and 79% did not use a formal algorithm to detect abnormal growth on growth charts. Among the 21% of paediatricians who used algorithms, many used non-algorithmic simple thresholds for height and weight and none used the algorithms published in the international literature. In all, 69% of paediatricians declared that a validated algorithm to monitor growth would be useful in daily practice. We found important between-country variations.

CONCLUSION

The varied growth-monitoring practices declared by primary care paediatricians reveals the need for standardization and evidence-based algorithms to define abnormal growth and the development of software that would use such algorithms.

摘要

目的

我们旨在研究欧洲初级保健儿科医生在生长监测方面的现行做法,并探讨他们在这一领域的需求。

方法

我们开发了一项横断面、匿名在线调查,并联系了在 18 个欧洲国家的国家目录中列出的初级保健儿科医生,这些国家都有一个初级保健儿科医生联合会。儿科医生于 2011 年 4 月至 9 月期间参与了这项调查。

结果

在来自 11 个欧洲国家的 1198 名儿科医生中(应答率为 13%),29%的医生使用了 2006 年世界卫生组织多中心生长参考研究生长图表,69%的医生使用了国家生长图表;61%的医生使用软件绘制生长图表,79%的医生在生长图表上没有使用正式的算法来检测生长异常。在使用算法的 21%的儿科医生中,许多人使用了身高和体重的非算法简单阈值,没有人使用国际文献中公布的算法。总的来说,69%的儿科医生表示,在日常实践中,一个经过验证的算法来监测生长将是有用的。我们发现了重要的国家间差异。

结论

初级保健儿科医生所报告的不同的生长监测做法表明需要标准化和基于证据的算法来定义生长异常,并开发使用此类算法的软件。

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