%0 Journal Article
%T Clinical Training of Primary Health Care Physicians to Reduce False Positive Diagnoses of Pediatric Urinary Tract Infections | OMICS International
%A Greiner F
%A Mon¨¢rrez-Espino J
%A Tejada-Tayabas LM
%A Urrutia-Herrera D
%J -
%D 2016
%R 10.4172/2161-0711.1000412
%X Background: Presumptive clinical diagnosis of£¿pediatric urinary tract infections (UTI) remains in practice in many£¿low- and middle-income countries in spite of its limited accuracy; improving its precision could be potentially useful£¿until more accurate methods can be implemented in resource-limited locations. Objective: To assess whether clinical training can result in a reduction of false positive diagnoses of pediatric£¿UTIs. Methods: A non-randomized pragmatic trial was conducted in six medical units. Each arm included doctors from£¿two units. Those in the first (IG9, n=14) and second (IG20, n=14) group received 9 h and 20 h training, respectively;£¿the control group (CG, n=17) received none. Training in the IG9 consisted of three sessions lasting 3 h each, one£¿per week over three consecutive weeks, and for the IG20 training spread over five weeks with two 2 h sessions per£¿week. Sessions were led by an expert pediatrician covering relevant UTI topics; focus was given on common signs£¿and symptoms including fever of unknown origin, urinary urgency, hematuria, dysuria, fetid urine, and suprapubic£¿pain. A total of 134 children between two months and nine years were diagnosed; 41, 44, and 49 from the CG, IG9£¿and IG20, respectively. The main measure of effect was the difference in the proportions of accurate positive clinical£¿diagnoses between the trained groups and the control using urine culture as standard. Adjusted odds ratios (OR)£¿from binary logistic regression were computed to estimate the probability of correctly diagnosing a UTI adjusting by£¿physicians¡¯ sex, age, years of experience, postgraduate education, and £¿re-training knowledge. Results: The proportion of accurate diagnoses was 39.0, 27.3 and 32.7% in the CG, IG9 and IG20, respectively.£¿Doctors trained for 9 or 20 h had a non-significantly lower chance of a correct diagnosis (OR; 95% CI for IG9=0.57;0.21-1.5, IG20=0.55; 0.21-1.4). Conclusion: Training did not reduce false positives diagnoses. Confirmatory methods are required to diagnose£¿UTIs in children with symptomatology
%K Clinical diagnosis
%K Mexico
%K Training
%K Pediatric
%K Urinary tract infection
%K omics
%K open access
%K omics publishing group
%K open access publisher
%K open access publishers
%K open access publications
%K open access journals
%K open access artcles
%K omics group
%K omicsonline
%U https://www.omicsonline.org/open-access/clinical-training-of-primary-health-care-physicians-to-reduce-false-positivediagnoses-of-pediatric-urinary-tract-infections-2161-0711-1000412.php?aid=72197