[Esophageal pH-metry. Evaluation of prescriptions at the Robert-Debré Hospital (Paris)].
OBJECTIVE
To record orders for esophageal pH-metry at the Robert-Debré hospital in Paris and to assess the quality and pertinence on the order.


METHODS
A prospective survey of all children who underwent pH-metry during the month of February 1996 was conducted. There were 11 children included in the study.


RESULTS
Half of the pH-metries were performed in inpatients and half in outpatients including 18% scheduled directly by the exploration unit. The order did not provide any reason for the exploration in 15% of the cases (42% of those scheduled by the unit). When a reason was explained, the order described the clinical context in 86% of the cases but did not give any information on ongoing treatment in 40%. Clinical indications mentioned respiratory or ear-nose-throat disease in 70% of the cases and regurgitations or vomiting in 42%. Pathological reflux was diagnosed in one-third of the explorations. An anti-reflux treatment was prescribed for half of the patients. In reference to the official prescription guidelines in France (Référence Médicale Opposable, RMO), 72% of the orders were pertinent, 10% were questionable, 10% did not comply to official guidelines, and 8% could not be classified due to lack of information.


CONCLUSIONS
These findings point out that the official guidelines may be of questionable value in the hospital setting.
Rachou
E
E
Service de Santé publique, Hôpital Robert-Debré, Paris.
Faure
C
C
Lombrail
P
P
Navarro
J
J
D000293:Adolescent; D000553:Ambulatory Care; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005260:Female; D005764:Gastroesophageal Reflux / Q000517:prevention & control* / Q000628:therapy; D006760:Hospitalization; D006779:Hospitals, Public; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010297:Paris; D055656:Prescriptions; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000628:therapy; D011795:Surveys and Questionnaires