Jacobs School Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Department of Psychology, Georgia Southern University, Statesboro, GA, USA.
Am J Otolaryngol. 2024 Jul-Aug;45(4):104322. doi: 10.1016/j.amjoto.2024.104322. Epub 2024 Apr 21.
Pediatric patients and their caregivers may receive information from their primary care physician (PCP) that does not match current American Academy of Otolaryngology (AAO) guidelines. The purpose of this study is to evaluate the frequency of parents deciding to seek a second opinion based on the demographics of pediatric otolaryngologists who deliver guideline supported advice, contrary to advice from their child's PCP.
A survey was distributed to parents in a pediatric otolaryngology clinic between June 2021 and July 2023. Demographics included parent age category, gender, race, and age of youngest child. The survey included a scenario depicting recurrent otitis media with clear ears and a suggestion to defer tympanostomy tube insertion per AAO guidelines after their child's PCP recommended tubes. Thirteen variations of otolaryngologist photos were used in the case, including a control case with no picture.
Of the 658 participants, 460 (69.9 %) were female. 551 (83.7 %) were aged 30-49 years, 70 (10.7 %) were younger, and 37 (5.6 %) were older. 545 (82.8 %) were White, 30 (4.6 %) were Black, 20 (3.0 %) were Asian, and 31 (4.7 %) were Hispanic. 39.9 % of parents would seek a second opinion if an otolaryngologist recommended watchful waiting following evaluation of their child's otitis media. Participants given the control case were 2.23 times more likely to listen to the otolaryngologist's advice (p = .025). If a picture was provided, respondents were more likely to follow advice given if the pictured otolaryngologist was female (p = .025, OR = 1.47) or Asian (p = .042, OR = 1.53).
In this group, there is evidence that physician race and gender may influence decision making when considering action versus monitoring in the context of recurrent otitis media.
儿科患者及其照顾者可能会从初级保健医生（PCP）那里获得与美国耳鼻喉科学院（AAO）当前指南不符的信息。本研究的目的是评估根据提供指南支持建议的儿科耳鼻喉科医生的人口统计学特征，父母决定寻求第二意见的频率，与孩子的 PCP 建议相反。
2021 年 6 月至 2023 年 7 月期间，在一家儿科耳鼻喉科诊所向父母分发了一份调查问卷。人口统计学特征包括父母年龄类别、性别、种族和最小孩子的年龄。调查包括一个场景，描述了反复性中耳炎，耳朵清晰，并建议根据 AAO 指南推迟鼓膜切开术管插入，而不是根据孩子的 PCP 建议插入管。在该病例中使用了 13 种耳鼻喉科医生照片的变体，包括一个没有照片的对照病例。
在 658 名参与者中，460 名（69.9%）为女性。551 名（83.7%）年龄在 30-49 岁之间，70 名（10.7%）年龄较小，37 名（5.6%）年龄较大。545 名（82.8%）为白人，30 名（4.6%）为黑人，20 名（3.0%）为亚洲人，31 名（4.7%）为西班牙裔。如果耳鼻喉科医生建议在评估孩子的中耳炎后进行观察等待，39.9%的父母会寻求第二意见。如果提供了病例，参与者更有可能听从耳鼻喉科医生的建议（p=0.025）。如果提供了照片，受访者更有可能听从女性（p=0.025，OR=1.47）或亚洲人（p=0.042，OR=1.53）的耳鼻喉科医生的建议。
在这组人中，有证据表明，在考虑复发性中耳炎时，医生的种族和性别可能会影响决策，决定采取行动还是监测。
