%0 Journal Article
%T Patients¡¯ vs. Physicians¡¯ Assessments of Emergencies: The Prudent Layperson Standard
%A Langdorf
%A Mark I
%A Bearie
%A Brian J
%A Kazzi
%A A. Antoine
%A Blasko
%A Barbara
%J Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health
%D 2003
%I UC Irvine Health School of Medicine.
%X Objective: To compare perception of the need for emergency care by emergency department (ED) patients vs. emergency physicians (EPs). Methods: Mailed survey to EPs and a convenience sample of ED patients. Survey rated urgency of acute sore throat, ankle injury, abdominal pain, and hemiparesis, as well as the best definition of ¡°emergency.¡± Responses were compared with chi-square (p < .05). Results: 119/140 (85%) of EPs and 1453 ED patients responded. EPs were more likely to judge acute abdominal pain (79.8% vs. 43.4%, p < 0.001, odds ratio (OR) 5.16, 95% confidence interval (CI) 3.19-8.40) and hemiparesis (100% vs. 82.6%, p < 0.001, OR 24.9, 95% CI 3.75-94.4) as an emergency. Similar proportions of ED patients and EPs considered sore throat (12.2% vs. 7.6%, p = 0.18, OR 0.59, CI 0.27-1.23) and ankle injury (46.9% vs. 38.6%, p = 0.10, OR 0.71, CI 0.48-1.06) an emergency. EPs (35%) and ED patients (40%) agreed to a similar degree with the ¡°prudent layperson¡± definition, ¡°a condition that may result in death, permanent disability, or severe pain.¡± (p = .36, OR 1.22, CI 0.81-1.84). EPs were more likely to add, ¡°the condition prevented work,¡± (27% vs. 16%, p = 0.003, OR 0.51, CI 0.33-0.81). Patients more often added, ¡°occurred outside business hours¡± (15% vs. 4%, p = 0.002, OR 4.0, CI = 1.5-11.3). Conclusion: For serious complaints, ED patients¡¯ thresholds for seeking care are higher than judged appropriate by EPs. Stroke is not uniformly recognized as an emergency. Absent consensus for the ¡°correct¡± threshold, the prudent layperson standard is appropriate.
%U http://escholarship.org/uc/item/8nm8549k