Diagnostic value of infantile stridor: a perceptual test.
BACKGROUND
stridor is the most common presenting symptom of pediatric airway obstruction, yet its value in clinical diagnosis is undetermined. The purpose of this study was to determine what diagnostic information was available to clinicians based entirely on listening to infantile stridor.


METHODS
ten taped samples of stridor and corresponding clinical summaries were independently scored by Pediatric Otolaryngologists and their trainees. Respondents were asked to score the 'perceived' severity of the stridor based on their aural perception. Participants were recruited by an advertisement on the Internet Pediatric Otolaryngology forum. Thirty-eight consultants and 22 trainees responded. The responses were compared to known outcomes in the ten patients presented.


RESULTS
listening to stridor in isolation resulted in respondents performing at the level of chance when their score of 'perceived' severity was compared to the known clinical outcome. When the clinical summaries (of the same patients) were scored, the level of performance significantly improved (P < 0.001). There was no difference in the level of performance when responses of trainees were compared with consultants, although there was a trend towards improved performance by the consultants.


CONCLUSIONS
the importance of infantile stridor judged in isolation is of limited diagnostic value. Clinical information contributes significantly to the rating of stridor severity. The combination of both clinical and auditory information will likely improve diagnostic acumen.
Papsin
B C
BC
Department of Pediatric Otolaryngology, The Hospital for Sick Children, Toronto, Ont., Canada.
Abel
S M
SM
Leighton
S E
SE
D002983:Clinical Competence; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010465:Perception; D012135:Respiratory Sounds / Q000175:diagnosis / Q000209:etiology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013637:Tape Recording