Incorporating patient preferences into practice guidelines: management of children with fever without source.
OBJECTIVE
To evaluate parent preferences for the therapy of young children with fever without source.


METHODS
Consecutive parents, not in a medical profession, of children less than 36 months old.


METHODS
Pediatric clinic of a university teaching hospital.


METHODS
During individual interviews at the time of their child's clinic visit, parents were presented with a case scenario and two treatment options and the risks, outcomes, and cost associated with each.


METHODS
Parent preferences for alternative treatment strategies.


RESULTS
All parents correctly identified the management strategy with the higher probability of an adverse outcome. Seventy-one percent chose the option with less testing and treatment and the greater risk of an adverse outcome. Parents' reasons for this choice were fewer painful tests and procedures (36%), less time waiting (32%), smaller chance of unnecessary antibiotics (23%), and ability to return if their child's condition deteriorated (22%). Thirty-two percent of parents indicated that cost was a factor in their decision. Age, gender, education, and/or number of children was not associated with parents' treatment preferences.


CONCLUSIONS
Parents' preferences may be considered when determining how to manage febrile infants and children.
Oppenheim
P I
PI
UCLA School of Medicine.
Sotiropoulos
G
G
Baraff
L J
LJ
D000367:Age Factors; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D002755:Choice Behavior; D002985:Clinical Protocols; D004635:Emergency Medicine / Q000379:methods* / Q000592:standards; D005069:Evaluation Studies as Topic; D005249:Fees and Charges; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007258:Informed Consent; D008297:Male; D010290:Parents / Q000523:psychology*; D010358:Patient Participation; D017410:Practice Guidelines as Topic; D012309:Risk-Taking; D016896:Treatment Outcome