[Do clinical decision models improve the triage of acutely ill children?].
Acute infection is the most common presentation of children in primary care, with only a few having serious infections. To avoid complications, early recognition and appropriate referral are essential. Clinical decision models have the potential to improve diagnostic decision-making for these serious conditions. Although many models have been developed, few have proven cost-effective. A recent model developed in acutely ill children presenting in Belgian primary care and validated in a new cohort has been shown to adequately identify children that are hospitalised with acute infections. The results are impressive but raise questions about generalisability and cost-effectiveness. In conclusion, clinical decision models appear currently incapable of improving decision-making in acutely ill children. As an alternative, we should consider asking the general practitioner to perform telephone triage.
Universitair Medisch Centrum Groningen, afd. Huisartsgeneeskunde, Groningen.
Marjolein Y
MY
Berger
D000208:Acute Disease / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003657:Decision Making; D058005:General Practitioners; D006801:Humans; D011320:Primary Health Care / Q000592:standards*; D012017:Referral and Consultation; D014218:Triage / Q000379:methods*