School of Medicine, University of Michigan, Ann Arbor, MI, USA.
Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.
Childs Nerv Syst. 2021 Dec;37(12):3797-3807. doi: 10.1007/s00381-021-05310-9. Epub 2021 Aug 18.
Early referral of neonatal brachial plexus palsy (NBPP) patients to multidisciplinary clinics is critical for timely diagnosis, treatment, and improved functional outcomes. In Saudi Arabia, inadequate knowledge regarding NBPP is a reason for delayed referral. We aimed to evaluate the knowledge of North American healthcare providers (HCPs) regarding the diagnosis, management, and prognosis of NBPP.
A 12-question survey regarding NBPP was distributed via electronic and paper formats to North American providers from various referring and treating specialties. NBPP knowledge was compared between Saudi Arabian vs. North American providers, referring vs. treating specialties, academic vs. community hospitals, and providers with self-reported confidence vs. nonconfidence in NBPP knowledge.
Of the 273 surveys collected, 45% were from referring providers and 55% were from treating providers. Saudi Arabian and North American HCPs demonstrated similar NBPP knowledge except for potential etiologies for NBPP and surgery timing. In North America, referring and treating providers had similar overall knowledge of NBPP but lacked familiarity with its natural history. A knowledge gap existed between academic and community hospitals regarding timing of referral/initiation of physical/occupational therapy (PT/OT) and Horner's syndrome. Providers with self-reported confidence in treating NBPP had greater knowledge of types of NBPP and timing for PT/OT initiation.
Overall, North American providers demonstrated adequate knowledge of NBPP. However, both eastern and western physicians remain overly optimistic in believing that most infants recover spontaneously. This study revealed a unique and universal knowledge gap in NBPP diagnosis, referral, and management worldwide. Continuous efforts to increase NBPP knowledge are indicated.
新生儿臂丛神经麻痹（NBPP）患者尽早转至多学科诊所对于及时诊断、治疗和改善功能预后至关重要。在沙特阿拉伯，对 NBPP 的认识不足是导致转诊延迟的一个原因。我们旨在评估北美医疗保健提供者（HCP）对 NBPP 的诊断、管理和预后的了解程度。
通过电子和纸质格式向来自不同转诊和治疗专业的北美提供者分发了一份关于 NBPP 的 12 个问题的调查。比较了沙特阿拉伯和北美提供者、转诊和治疗专业、学术和社区医院以及自我报告对 NBPP 知识有信心和无信心的提供者之间的 NBPP 知识。
在收集的 273 份调查中，45%来自转诊提供者，55%来自治疗提供者。沙特阿拉伯和北美 HCP 对 NBPP 的知识相似，但对潜在的 NBPP 病因和手术时机的认识不同。在北美，转诊和治疗提供者对 NBPP 的整体知识相似，但对其自然病史缺乏了解。学术和社区医院在转诊/开始物理/职业治疗（PT/OT）和霍纳氏综合征的时间方面存在知识差距。自我报告有信心治疗 NBPP 的提供者对 NBPP 的类型和开始 PT/OT 的时间有更多的了解。
总体而言，北美提供者对 NBPP 有足够的了解。然而，东部和西部的医生仍然过于乐观地认为大多数婴儿会自发恢复。这项研究揭示了全球范围内在 NBPP 诊断、转诊和管理方面存在独特而普遍的知识差距。需要不断努力提高对 NBPP 的认识。
