Clinician factors associated with delayed diagnosis of appendicitis
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Abstract
Objectives
To evaluate the association of clinician demographics and practice patterns with delayed diagnosis of appendicitis.
Methods
We included children with appendicitis at 13 regional emergency departments (EDs). We screened patients with a previous ED visit within 7 days for delayed diagnosis by chart review. We evaluated the association of clinician characteristics using logistic regression with random intercepts for site and clinician and delay as the outcome.
Results
Among 7,452 children with appendicitis, 105 (1.4%) had delayed diagnosis. Clinicians in the lowest quartile of obtaining blood in their general practice were more likely to have delayed diagnosis (odds ratio 4.9 compared to highest quartile, 95% confidence interval 1.8, 13.8). Clinicians’ imaging rates, specialty, sex, and experience were not associated with delayed diagnosis.
Conclusions
Clinicians who used more blood tests in their general practice had a lower risk of delayed diagnosis of appendicitis, possible evidence that lower risk tolerance has benefits.
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Research funding: Dr. Michelson received funding through the CRICO Foundation.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: The local Institutional Review Board deemed the study exempt from review.
References
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© 2022 Walter de Gruyter GmbH, Berlin/Boston
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Artikel in diesem Heft
- Frontmatter
- Editorials
- An equation for excellence in clinical reasoning
- Quantifying diagnostic excellence
- Review
- A scoping review of distributed cognition in acute care clinical decision-making
- Opinion Papers
- Context matters: toward a multilevel perspective on context in clinical reasoning and error
- Occam’s razor and Hickam’s dictum: a dermatologic perspective
- Original Articles
- Differences in clinical reasoning between female and male medical students
- Introducing second-year medical students to diagnostic reasoning concepts and skills via a virtual curriculum
- Bad things can happen: are medical students aware of patient centered care and safety?
- Impact of diagnostic checklists on the interpretation of normal and abnormal electrocardiograms
- Cerebrospinal fluid lactate as a predictive biomarker for tuberculous meningitis diagnosis
- Empowering quality data – the Gordian knot of bringing real innovation into healthcare system
- Collective intelligence improves probabilistic diagnostic assessments
- Why people fail to participate in annual skin cancer screening: creation of the perceptions of annual skin cancer screening scale (PASCSS)
- Instructions on appropriate fasting prior to phlebotomy; effects on patient awareness, preparation, and biochemical parameters
- Clinician factors associated with delayed diagnosis of appendicitis
- Real-world assessment of the clinical performance of COVID-VIRO ALL IN rapid SARS-CoV-2 antigen test
- Lack of a prompt normalization of immunological parameters is associated with long-term care and poor prognosis in COVID-19 affected patients receiving convalescent plasma: a single center experience
- Letters to the Editor
- Uncontrolled confounding in COVID-19 epidemiology
- VAPES: a new mnemonic for considering paroxysmal disorders
- Congress Abstracts
- SIDM2022 15th Annual International Conference
