Veronica Frey Esgård, Ida Lindman, Anja Maria Braend, Guro Haugen Fossum, Thorbjörn Lundberg, Anna Moberg, Lena Nordeman, Chrysoula Papachristodoulou, Pär-Daniel Sundvall
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引用次数: 0
Abstract
Background: Otomicroscopy and pneumatic methods are superior to otoscopy alone in diagnosing acute otitis media (AOM). There is a lack of knowledge regarding the use of different diagnostic methods for AOM in primary health care in Sweden and Norway.
Methods: This cross-sectional study included a questionnaire completed by general practitioners (GPs) and specialist trainees (STs/residents/registrars) working in primary care in Sweden and Norway. Multivariable binary logistic regressions were performed to evaluate the use of diagnostic methods and written advice adjusted for educational level, sex and country.
Results: Otoscopy was the most frequently used method. Sweden had greater access to the more accurate diagnostic methods. In Norway, the following methods were used to a lesser extent: pneumatic otoscopy, adjusted OR 0.15 (95% CI 0.10-0.23; p < .001), otomicroscopy, adjusted OR 0.013 (95% CI 0.070-0.027; p < .001), pneumatic otomicroscopy, adjusted OR 0.028 (95% CI 0.010-0.078; p < .001) and tympanometry, adjusted OR 0.31 (95% CI 0.21-0.45; p < .001). Written advice was used to a greater extent in Norway, adjusted OR 4.5 (95% CI 3.1-6.7; p < .001). The STs used pneumatic otoscopy and pneumatic otomicroscopy to a lesser extent, adjusted OR 0.65 (95% CI 0.45-0.93; p = .019) and 0.63 (95% CI 0.43-0.92; p = .016).
Conclusions: Swedish physicians both used and had greater access to the significantly better diagnostic methods compared with Norwegian physicians while the opposite applied to the use of written information. The GPs used pneumatic otoscopy and pneumatic otomicroscopy to a greater extent than STs. Compared with 2012, the Swedish physicians now more frequently used pneumatic otoscopy.
背景:在诊断急性中耳炎(AOM)方面,耳显微镜检查和气动方法优于单纯的耳内镜检查。瑞典和挪威的基层医疗机构对使用不同诊断方法诊断急性中耳炎还缺乏了解:这项横断面研究包括一份由瑞典和挪威从事初级保健工作的全科医生(GPs)和专科受训人员(STs/住院医师/注册医师)填写的调查问卷。对诊断方法和书面建议的使用进行了多变量二元逻辑回归评估,并对教育水平、性别和国家进行了调整:结果:耳镜检查是最常用的方法。瑞典有更多机会使用更准确的诊断方法。在挪威,以下方法的使用率较低:气动耳镜检查,调整后的OR值为0.15(95% CI 0.10-0.23; p p p p p = .019)和0.63(95% CI 0.43-0.92; p = .016):结论:与挪威医生相比,瑞典医生使用和获得明显更好的诊断方法的机会更多,而使用书面信息的情况则恰恰相反。全科医生使用气动耳镜和气动耳显微镜的程度高于耳科ST医生。与2012年相比,瑞典医生现在更经常使用气动耳镜检查。
期刊介绍:
Scandinavian Journal of Primary Health Care is an international online open access journal publishing articles with relevance to general practice and primary health care. Focusing on the continuous professional development in family medicine the journal addresses clinical, epidemiological and humanistic topics in relation to the daily clinical practice.
Scandinavian Journal of Primary Health Care is owned by the members of the National Colleges of General Practice in the five Nordic countries through the Nordic Federation of General Practice (NFGP). The journal includes original research on topics related to general practice and family medicine, and publishes both quantitative and qualitative original research, editorials, discussion and analysis papers and reviews to facilitate continuing professional development in family medicine. The journal''s topics range broadly and include:
• Clinical family medicine
• Epidemiological research
• Qualitative research
• Health services research.