Linked Life Data

18487856

Source:http://linkedlifedata.com/resource/pubmed/id/18487856

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2008-5-19
pubmed:abstractText
Improving diagnostic accuracy is essential. The extent of diagnostic uncertainty at patient admission is not well described in critically ill children. Therefore, we studied the extent that pediatric trainee diagnostic performance could be improved with the aid of a computerized diagnostic tool. Data regarding patient admissions to five Pediatric Intensive Care Units were collected. Information included patients' clinical details, admitting team's diagnostic workup and discharge diagnosis. An attending physician assessed each case independently and suggested additional diagnostic possibilities. Diagnostic accuracy was calculated using the discharge diagnosis as the gold standard. 206 out of 927 patients (22.2%) admitted to the PICUs did not have an established diagnosis at admission. The trainee teams considered a median of three diagnoses in their workup (IQR 3-5) and made an accurate diagnosis in 89.4% cases (95% CI 84.6%-94.2%). Diagnostic accuracy improved to 92.5% with use of the diagnostic tool alone, and to 95% with the addition of attending physicians' diagnostic suggestions. We conclude that a modest proportion of admissions to these PICUs were characterized by diagnostic uncertainty during initial assessment. Although there was a relatively high accuracy rate of initial assessment in our clinical setting, it was further improved by both the diagnostic tool and the physicians' diagnostic suggestions. It is plausible that the tool's utility would be even greater in clinical settings with less expertise in critical illness assessment, such as community hospitals, or emergency departments of non-training institutions. The role of diagnostic aids in the care of critically ill children merits further study.further study.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:issn
0928-7329
pubmed:author
pubmed:issnType
Print
pubmed:volume
16
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
103-10
pubmed:meshHeading
pubmed:year
2008
pubmed:articleTitle
An international assessment of a web-based diagnostic tool in critically ill children.
pubmed:affiliation
Penn State Children's Hospital and The Pennsylvania State University College of Medicine, Hershey, PA, USA. nthomas@psu.edu
pubmed:publicationType
Journal Article, Multicenter Study