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Parental and clinician agreement of illness severity in children with RTIs: Secondary analysis of data from a prospective cohort study

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Parental and clinician agreement of illness severity in children with RTIs : Secondary analysis of data from a prospective cohort study. / Van der Werf-Kok, Esther; Redmond, Niamh; Turnbull, Sophie; Thornton, Hannah; Thompson, Matthew; Little, Paul; Peters, TJ; Blair, Pete; Hay, Alastair.

In: British Journal of General Practice, Vol. 69, No. 681, 01.04.2019, p. E236-E245.

Research output: Contribution to journalArticle

Harvard

Van der Werf-Kok, E, Redmond, N, Turnbull, S, Thornton, H, Thompson, M, Little, P, Peters, TJ, Blair, P & Hay, A 2019, 'Parental and clinician agreement of illness severity in children with RTIs: Secondary analysis of data from a prospective cohort study', British Journal of General Practice, vol. 69, no. 681, pp. E236-E245. https://doi.org/10.3399/bjgp19X701837

APA

Van der Werf-Kok, E., Redmond, N., Turnbull, S., Thornton, H., Thompson, M., Little, P., ... Hay, A. (2019). Parental and clinician agreement of illness severity in children with RTIs: Secondary analysis of data from a prospective cohort study. British Journal of General Practice, 69(681), E236-E245. https://doi.org/10.3399/bjgp19X701837

Vancouver

Van der Werf-Kok E, Redmond N, Turnbull S, Thornton H, Thompson M, Little P et al. Parental and clinician agreement of illness severity in children with RTIs: Secondary analysis of data from a prospective cohort study. British Journal of General Practice. 2019 Apr 1;69(681):E236-E245. https://doi.org/10.3399/bjgp19X701837

Author

Van der Werf-Kok, Esther ; Redmond, Niamh ; Turnbull, Sophie ; Thornton, Hannah ; Thompson, Matthew ; Little, Paul ; Peters, TJ ; Blair, Pete ; Hay, Alastair. / Parental and clinician agreement of illness severity in children with RTIs : Secondary analysis of data from a prospective cohort study. In: British Journal of General Practice. 2019 ; Vol. 69, No. 681. pp. E236-E245.

Bibtex

@article{71cb840eb9454f58bd4d5a6eeb836238,
title = "Parental and clinician agreement of illness severity in children with RTIs: Secondary analysis of data from a prospective cohort study",
abstract = "Background Severity assessments of respiratory tract infection (RTI) in children are known to differ between parents and clinicians, but determinants of perceived severity are unknown.Aim To investigate the (dis)agreement between, and compare the determinants of, parent and clinician severity scores.Design and setting Secondary analysis of data from a prospective cohort study of 8394 children presenting to primary care with acute (≤28 days) cough and RTI.Method Data on sociodemographic factors, parent-reported symptoms, clinician-reported findings, and severity assessments were used. Kappa (κ)-statistics were used to investigate (dis) agreement, whereas multivariable logistic regression was used to identify the factors associated with illness severity.Results Parents reported higher illness severity (mean 5.2 [standard deviation (SD) 1.8], median 5 [interquartile range (IQR) 4–7]), than clinicians (mean 3.1 [SD 1.7], median 3 [IQR 2–4], P<0.0001). There was low positive correlation between these scores (+0.43) and poor inter-rater agreement between parents and clinicians (κ 0.049). The number of clinical signs was highly correlated with clinician scores (+0.71). Parent-reported symptoms (in the previous 24 hours) that were independently associated with higher illness severity scores, in order of importance, were: severe fever, severe cough, rapid breathing, severe reduced eating, moderate-to-severe reduced fluid intake, severe disturbed sleep, and change in cry. Three of these symptoms (severe fever, rapid breathing, and change in cry) along with inter/subcostal recession, crackles/crepitations, nasal flaring, wheeze, and drowsiness/irritability were associated with higher clinician scores.Conclusion Clinicians and parents use different factors and make different judgements about the severity of children’s RTI. Improved understanding of the factors that concern parents could improve parent–clinician communication and consultation outcomes.",
keywords = "Fever, Illness severity assessment, Primary health care, Respiratory tract infections",
author = "{Van der Werf-Kok}, Esther and Niamh Redmond and Sophie Turnbull and Hannah Thornton and Matthew Thompson and Paul Little and TJ Peters and Pete Blair and Alastair Hay",
year = "2019",
month = "4",
day = "1",
doi = "10.3399/bjgp19X701837",
language = "English",
volume = "69",
pages = "E236--E245",
journal = "British Journal of General Practice",
issn = "0960-1643",
publisher = "Royal College of General Practitioners",
number = "681",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - Parental and clinician agreement of illness severity in children with RTIs

T2 - Secondary analysis of data from a prospective cohort study

AU - Van der Werf-Kok, Esther

AU - Redmond, Niamh

AU - Turnbull, Sophie

AU - Thornton, Hannah

AU - Thompson, Matthew

AU - Little, Paul

AU - Peters, TJ

AU - Blair, Pete

AU - Hay, Alastair

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Background Severity assessments of respiratory tract infection (RTI) in children are known to differ between parents and clinicians, but determinants of perceived severity are unknown.Aim To investigate the (dis)agreement between, and compare the determinants of, parent and clinician severity scores.Design and setting Secondary analysis of data from a prospective cohort study of 8394 children presenting to primary care with acute (≤28 days) cough and RTI.Method Data on sociodemographic factors, parent-reported symptoms, clinician-reported findings, and severity assessments were used. Kappa (κ)-statistics were used to investigate (dis) agreement, whereas multivariable logistic regression was used to identify the factors associated with illness severity.Results Parents reported higher illness severity (mean 5.2 [standard deviation (SD) 1.8], median 5 [interquartile range (IQR) 4–7]), than clinicians (mean 3.1 [SD 1.7], median 3 [IQR 2–4], P<0.0001). There was low positive correlation between these scores (+0.43) and poor inter-rater agreement between parents and clinicians (κ 0.049). The number of clinical signs was highly correlated with clinician scores (+0.71). Parent-reported symptoms (in the previous 24 hours) that were independently associated with higher illness severity scores, in order of importance, were: severe fever, severe cough, rapid breathing, severe reduced eating, moderate-to-severe reduced fluid intake, severe disturbed sleep, and change in cry. Three of these symptoms (severe fever, rapid breathing, and change in cry) along with inter/subcostal recession, crackles/crepitations, nasal flaring, wheeze, and drowsiness/irritability were associated with higher clinician scores.Conclusion Clinicians and parents use different factors and make different judgements about the severity of children’s RTI. Improved understanding of the factors that concern parents could improve parent–clinician communication and consultation outcomes.

AB - Background Severity assessments of respiratory tract infection (RTI) in children are known to differ between parents and clinicians, but determinants of perceived severity are unknown.Aim To investigate the (dis)agreement between, and compare the determinants of, parent and clinician severity scores.Design and setting Secondary analysis of data from a prospective cohort study of 8394 children presenting to primary care with acute (≤28 days) cough and RTI.Method Data on sociodemographic factors, parent-reported symptoms, clinician-reported findings, and severity assessments were used. Kappa (κ)-statistics were used to investigate (dis) agreement, whereas multivariable logistic regression was used to identify the factors associated with illness severity.Results Parents reported higher illness severity (mean 5.2 [standard deviation (SD) 1.8], median 5 [interquartile range (IQR) 4–7]), than clinicians (mean 3.1 [SD 1.7], median 3 [IQR 2–4], P<0.0001). There was low positive correlation between these scores (+0.43) and poor inter-rater agreement between parents and clinicians (κ 0.049). The number of clinical signs was highly correlated with clinician scores (+0.71). Parent-reported symptoms (in the previous 24 hours) that were independently associated with higher illness severity scores, in order of importance, were: severe fever, severe cough, rapid breathing, severe reduced eating, moderate-to-severe reduced fluid intake, severe disturbed sleep, and change in cry. Three of these symptoms (severe fever, rapid breathing, and change in cry) along with inter/subcostal recession, crackles/crepitations, nasal flaring, wheeze, and drowsiness/irritability were associated with higher clinician scores.Conclusion Clinicians and parents use different factors and make different judgements about the severity of children’s RTI. Improved understanding of the factors that concern parents could improve parent–clinician communication and consultation outcomes.

KW - Fever

KW - Illness severity assessment

KW - Primary health care

KW - Respiratory tract infections

UR - http://www.scopus.com/inward/record.url?scp=85063948155&partnerID=8YFLogxK

U2 - 10.3399/bjgp19X701837

DO - 10.3399/bjgp19X701837

M3 - Article

C2 - 30858333

VL - 69

SP - E236-E245

JO - British Journal of General Practice

JF - British Journal of General Practice

SN - 0960-1643

IS - 681

ER -