Menz Timothy Joseph, Herzlinger Michael, Ross Albert, Zonfrillo Mark R
Division of Pediatric Gastroenterology, Hasbro Children's Hospital, Providence/Rhode Island Hospital, RI, USA.
Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA.
Glob Pediatr Health. 2019 Feb 26;6:2333794X19829757. doi: 10.1177/2333794X19829757. eCollection 2019.
Biliary atresia is a common cause of cholestasis in infants and is a time-sensitive diagnosis. A survey was distributed to pediatric primary care providers in order to assess variations in diagnosis and management of cholestasis. Participants were identified from physician parent groups on social media and regional pediatric residency programs. Information on knowledge and interpretation of screening tests, past experience/behavior, confidence, and comfort level managing cholestasis, as well as demographic information was collected. Out of 116 eligible respondents, 94.8% were confident in diagnosing hyperbilirubinemia but only 10.3% knew the biochemical definition of direct hyperbilirubinemia. Of the 56% of providers who had some knowledge of the guidelines, 18.5% stated the guidelines changed the way they evaluate cholestasis. These results demonstrate a gap in knowledge of diagnosing and evaluating cholestasis, which could provide the framework for standardized screening, leading to earlier identification of biliary atresia.
胆道闭锁是婴儿胆汁淤积的常见原因，且是一种对时间敏感的诊断。为了评估胆汁淤积诊断和管理方面的差异，向儿科初级保健提供者发放了一份调查问卷。参与者从社交媒体上的医师家长群体和地区儿科住院医师项目中确定。收集了关于筛查测试的知识和解读、过去的经验/行为、管理胆汁淤积的信心和舒适度，以及人口统计学信息。在116名符合条件的受访者中，94.8%对诊断高胆红素血症有信心，但只有10.3%知道直接高胆红素血症的生化定义。在了解一些指南的56%的提供者中，18.5%表示这些指南改变了他们评估胆汁淤积的方式。这些结果表明在诊断和评估胆汁淤积的知识方面存在差距，这可为标准化筛查提供框架，从而更早地识别胆道闭锁。
