Physicians should pay attention to their "gut feeling" that something may be seriously wrong when assessing a child with an infectious disease -- even if the clinical appearance is reassuring -- an observational study suggested.
Among 3,369 children whose primary care evaluation did not suggest a serious illness, six (0.2%) ultimately were admitted to the hospital with a severe infection, according to Ann Van den Bruel, MD, PhD, of the Radcliffe Observatory Quarter in Oxford, England, and colleagues.
The clinician's gut feeling that the child was seriously ill considerably increased the chance that a severe infection was present, with a likelihood ratio of 25.5 (95% CI 7.9 to 82), and heeding the feeling might have prevented two cases from being overlooked (33%, 95% CI 0.95 to 1.75), the researchers reported online in BMJ.
Among 3,369 children whose primary care evaluation did not suggest a serious illness, six (0.2%) ultimately were admitted to the hospital with a severe infection, according to Ann Van den Bruel, MD, PhD, of the Radcliffe Observatory Quarter in Oxford, England, and colleagues.
The clinician's gut feeling that the child was seriously ill considerably increased the chance that a severe infection was present, with a likelihood ratio of 25.5 (95% CI 7.9 to 82), and heeding the feeling might have prevented two cases from being overlooked (33%, 95% CI 0.95 to 1.75), the researchers reported online in BMJ.
Sat Oct 6 10:14:57 2012