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Impact of delay in asthma diagnosis on chest X-ray and antibiotic utilization by clinicians

机译：哮喘诊断延迟对临床医生的胸部X光检查和抗生素利用的影响

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Objective. To evaluate the effect of the timeliness of asthma diagnosis on chest X-ray (CXR) and antibiotic utilization in children. Patients and methods. This was a retrospective cohort study of 276 asthmatic children aged 512 years from Rochester, Minnesota. From the time when children met our predetermined asthma criteria, the frequency of CXR and antibiotic utilizations for respiratory illnesses were collected from medical records until age 18 years. Using a Poisson regression model, the frequency of CXR and antibiotic utilizations were compared in children with timely, delayed, or no clinician diagnosis of asthma. Results. Of the 276 asthmatic patients, 97 (35%) had a timely diagnosis, 122 (44%) had a delayed diagnosis, while 57 patients (21%) had no clinician diagnosis of asthma. There was no significant difference in CXR or antibiotic utilization for respiratory illness between these groups. In addition, this was true for the comparison between the timely diagnosed group and the delayed diagnosed group combining both the group with a delay in asthma diagnosis and the group who never had asthma diagnosis. Conclusions. A delay in the diagnosis of asthma in children is common and overall it may not influence antibiotic and CXR utilization for respiratory symptoms by clinicians. However, its impact on access to asthma-related therapies and other healthcare utilizations could be possible and was not assessed in this study. Given the limitations of our study, a larger prospective study needs to be considered.
机译：目的。为了评估哮喘的及时诊断对儿童胸部X线（CXR）和抗生素利用的影响。患者和方法。这是一项对来自明尼苏达州罗切斯特的276名512岁的哮喘儿童进行的回顾性队列研究。从儿童达到我们预定的哮喘标准之时起，就从医疗记录中收集CXR和呼吸道疾病抗生素的使用频率，直至18岁。使用Poisson回归模型，比较了及时，延迟或没有临床医生诊断为哮喘的儿童的CXR频率和抗生素使用率。结果。在276名哮喘患者中，有97名（35％）能够及时诊断，122名（44％）具有延迟诊断，而57名患者（21％）没有临床医生诊断为哮喘。这些人群之间在呼吸系统疾病的CXR或抗生素利用方面无显着差异。另外，对于及时诊断组与延迟诊断组之间的比较，将哮喘诊断延迟的组与从未进行过哮喘诊断的组进行了比较，这是正确的。结论。儿童哮喘的诊断延迟是普遍现象，总体而言，它可能不会影响临床医生对呼吸道症状使用抗生素和CXR。但是，它对获得哮喘相关疗法和其他医疗保健用途的影响是可能的，本研究未对此进行评估。考虑到我们研究的局限性，需要考虑进行更大范围的前瞻性研究。

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