What is important to the GP in recognizing acute appendicitis in children: a delphi study

BMC Primary Care

Research

Arjan B. Ahmeti¹  Guus C.G.H. Blok¹  Gea A. Holtman¹  Marjolein Y. Berger¹ 

[1] Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Groningen, The Netherlands;

关键词: Primary Health Care;    Appendicitis;    Child;    Abdominal Pain;    Delphi Technique;    Medical Records;   

DOI  :  10.1186/s12875-023-02167-6

 received in 2023-06-02, accepted in 2023-09-30,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundFor diagnostic research on appendicitis in registration data, insight is needed in the way GPs generate medical records. We aimed to reach a consensus on the features that GPs consider important in the consultation and medical records when evaluating a child with suspected appendicitis.MethodsWe performed a three-round Delphi study among Dutch GPs selected by purposive sampling. An initial feature list was created based on a literature search and features in the relevant Dutch guideline. Finally, using a vignette describing a child who needed later reassessment, we asked participants to complete an online questionnaire about which consultation features should be addressed and recorded.ResultsA literature review and Dutch guideline yielded 95 consultation features. All three rounds were completed by 22 GPs, with the final consensus list containing 26 symptoms, 29 physical assessments and signs, 2 additional tests, and 8 further actions (including safety-netting, i.e., informing the patient about when to contact the GP again). Of these, participants reached consensus that 37 should be actively addressed and that 20 need to be recorded if findings are negative.ConclusionsGPs agreed that negative findings do not need to be recorded for most features and that records should include the prognostic and safety-netting advice given. The results have implications in three main domains: for research, that negative findings are likely to be missing; for medicolegal purposes, that documentation cannot be expected to be complete; and for clinical practice, that safety-netting advice should be given and documented.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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